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Kidney Injury
The kidneys are well protected organs. They are set deep into the abdomen andshielded by the lower ribs. Because of their location, they can be injured in blows to the mid-back or flank. Fractures involving the posterior (back) aspects of ribs 10, 11, and 12 may cause damage to a kidney. It is fortunate that most blunt (contusions) injuries to the kidneys heal without surgical intervention. The kidney may also be injured from a stab wound to the back. Common symptoms include pain and tenderness to the mid-back and flank. Any history of a blow to that area is important. Associated findings of low rib fractures should alert the physician to search for possible kidney trauma.
Blood may be visible in the urine as a pinkish discoloration, but is more commonly detected through urinalysis (microscopic analysis). Evaluation will include physical examination for bruising to the mid-back or flanks. Presence of gross, or microscopic blood in the urine may indicate the need for intravenous pyelography (IVP) or CT-scanning of the abdomen. Both tests can reveal kidney injury. Intravenous pyelography is similar to a plain x-ray. First, the injection of a radiopaque contrast dye into the patient's vein is required. Minor kidney injuries may be managed conservatively with a follow-up urinalysis to determine whether the blood is clearing and infection is not occurring. Major kidney trauma can result in the surgical removal of the damaged kidney. The remaining kidney will enlarge to compensate for the duties of the missing organ. Damage to other parts of the genitourinary tract (bladder, ureter, and urethra) may also result in blood contaminated urine.
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 Hip Dislocation
Hip Fracture
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Kidney Injury
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