GREENLIGHT LASER PROSTATECTOMY PROCEDURAL TECHNIQUE Dr Charles Chabert.
Urological Causes of an Acute Abdomen Dr Charles Chabert.
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Transcript of Urological Causes of an Acute Abdomen Dr Charles Chabert.
![Page 1: Urological Causes of an Acute Abdomen Dr Charles Chabert.](https://reader036.fdocuments.in/reader036/viewer/2022062422/56649ec75503460f94bd3724/html5/thumbnails/1.jpg)
Urological Causes of an Acute Abdomen
Dr Charles Chabert
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Renal Trauma
1-5% of all Trauma
50% all GU Trauma
Both kidneys equally affected
Majority blunt trauma
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Renal Trauma
Haematuria
Absent in 40% pedicle injuries
Does not differentiate minor from major
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Renal Imaging
Who and How?
Contrast CT
Unstable patients - One shot IVP
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Injury Scaling
1. Subcapsular haematoma
2. Cortical laceration <1cm
3. Cortical laceration >1cm
4. A. Cortical laceration into collecting system
B. Vascular injury with contained haematoma
5. A. Shattered kidney
B. Avulsion
Organ injury Scaling AAST
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Renal Trauma
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Renal Trauma – grade 5
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Renal Trauma
![Page 9: Urological Causes of an Acute Abdomen Dr Charles Chabert.](https://reader036.fdocuments.in/reader036/viewer/2022062422/56649ec75503460f94bd3724/html5/thumbnails/9.jpg)
Renal Trauma
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Grade 5
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Grade 5
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Gunshot injury
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Gunshot injury
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Gunshot injury
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Indications For Exploration
Persistent , life threatening haemorrhage
Pulsatile, expanding haematoma
Grade 5 injuries
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Ureteric Colic
Pain
Haematuria
Sepsis
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Ureteric Colic
Urinalysis
FBC, EUC
Imaging: CT scan & KUB Xray
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Ureteric Colic
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Ureteric Colic
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Ureteric Colic
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Management
Analgesia
Hydration
Drainage renal unit:Pain
SepsisDeteriorating renal function
Single system
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Ureteric Trauma
< 1% renal trauma
Iatrogenic more common
Paediatric trauma - PUJ
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Bladder Trauma
Extraperitoneal or intraperitoneal
Extra- associated with pelvic fracture
Intra- associated with deceleration
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Bladder Trauma
Suprapubic pain
Haematuria
Retention
Peritoneal irritation
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Bladder trauma
Cystogram
CT Cystogram
Pevic X Ray
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Extraperitoneal Rupture
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Bladder Trauma
Principles of Treatment
Urethral drainage
Exploration and formal repair
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Summary
Urological trauma is rare
Treatment conservative
Stones – unilateral
Drainage for:
Pain
Sepsis
Deterioration renal function