Non-penetrating Injuries To The Kidneys, Ureters, Or Bladder

What are non-penetrating injuries to the kidneys, ureters, or bladder?

  • Non-penetrating injuries are also called blunt injuries. Blunt injuries are those that result from a direct blow to the abdomen or lower back area without an open wound. Blunt injuries to the kidneys, ureters, or bladder may include a tear, cut, or bruise to the organ. These injuries may lead to internal bleeding due to the organ rupturing (bursting) or blood vessel problems.

  • The kidneys are bean-shaped organs that remove unwanted chemicals and waste from your blood. These wastes are turned into urine by the kidneys. There is one kidney located on each side of the spine (backbone) in the back of your abdomen. The ureters are tubes that carry urine from the kidneys to the bladder. The bladder is a hollow, round organ that holds urine. It is small when empty and lies behind the pelvic bone in the front of the abdomen. When the bladder is full, it becomes round and it goes up into the lower part of the abdomen. Among the three, the kidneys are the most commonly injured.

What causes blunt injuries to the kidneys, ureters, or bladder?

  • Broken ribs or pelvic (hip) bones piercing the organ.

  • Car accidents.

  • Direct blows to the abdomen or lower back area, such as those received during a fight or when playing sports.

  • Heavy objects falling on the abdomen.

  • A sudden stop or decrease in speed of a very fast moving vehicle.

What are the signs and symptoms of blunt injuries to the kidneys, ureters, or bladder?

  • Abdominal pain, especially in the lower abdomen or lower back area. Your abdomen may also be tender and hard.

  • Blood in the urine or pink-to-red colored urine.

  • Bruising, swelling, or scratches over the injured area.

  • Fever, nausea (upset stomach), or vomiting (throwing up).

  • Signs of shock, including a fast pulse (heartbeat), low blood pressure, and pale skin.

  • Trouble urinating or passing little to no urine.

How are blunt injuries to the kidneys, ureters, or bladder diagnosed?

Many blunt injuries are not diagnosed right away, but are found after tests are done, or you start to show symptoms. Your caregiver will do a complete check-up of your body to look for problems or signs of injury. Certain tests use a special dye to help organs and structures show up better. Tell caregivers if you are allergic to shellfish (lobster, crab, or shrimp), as you may also be allergic to this dye. One or more of the following tests may be done:

  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.

  • Urine test: A sample of your urine is collected and tested for blood in your urine.

  • Imaging tests:

    • Abdominal ultrasound: This test is done so caregivers can see the tissues and organs of your abdomen. Gel will be put on your abdomen and a small sensor will be moved across your abdomen. The sensor uses sound waves to send pictures of your abdomen to a TV-like screen.

    • Angiography: This test looks for problems with blood flow in your abdomen. A catheter (long, thin, bendable tube) is placed in a blood vessel in your groin. The groin is the area where your abdomen meets your upper leg. A dye is put into the catheter. Pictures are taken using an x-ray or a CT scan after the dye goes to your abdominal organs.

    • Computerized tomography scan: This is also called CT scan. A special X-ray machine uses a computer to take pictures of different areas of your abdomen and pelvis. It may be used to look at your bones, organs, and blood vessels. Before taking the pictures, you may be given dye through an IV in your vein.

    • Cystogram: This is an x-ray test where a catheter is put into your bladder. Dye is put through the catheter into your bladder while x-rays are taken to see if it is damaged or leaking.

    • Cystoscopy: A cystoscopy allows caregivers to look for problems inside your bladder. A cystoscope is put into your bladder through your urethra. The urethra is the tube that urine flows through when you urinate. The cystoscope is a long tube with a lens and a light on the end. The scope may be hooked to a camera or monitor, and pictures may be taken. A tissue sample may also be taken during your cystoscopy. During this test, small tumors may be removed or bleeding may be stopped.

    • Magnetic resonance imaging scan: This test is also called an MRI. An MRI uses magnetic waves to take pictures of your abdomen. During an MRI, pictures are taken of your bones, abdominal or pelvic organs, or blood vessels. You will need to lie still during an MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This may cause serious injury.

    • X-rays: X-rays of different parts of your body may be taken. These may include x-rays of your kidneys, ureters, bladder, and pelvis. X-rays may help caregivers also look for broken bones or other injuries. You may be given dye as a shot into your vein, before having a kidneys, ureters, and bladder (KUB) x-ray. This dye will help these organs show up better in x-ray pictures. A KUB x-ray with dye is called an intravenous pyelogram (IVP).

How are blunt injuries to the kidneys, ureters, or bladder treated?

  • Watchful waiting: If your condition is stable and your injury is mild, watchful waiting may be all that is needed. Your caregiver will watch you closely for a period of time until your injury heals on its own. You may need to rest in bed and limit your activity.

  • Embolization: This is done to stop bleeding from an injured blood vessel. After doing an angiography, caregivers block off the bleeding by injecting a liquid, coil, or gel into the vessel.

  • Surgery: Open or laparoscopic surgery may be done to clean and repair an injured organ. Caregivers may use sutures (threads) to close a cut. Bleeding from blood vessels may be stopped by applying heat or closing them with sutures. A ureter that is cut into two may have its ends reattached. Surgery to take out all or part of the injured kidney, ureter, or bladder may be done. Sometimes, surgery to correct other problems or treat other injuries may be done first. You may need to have more than one surgery.
With treatment, such as surgery, your kidneys, ureters, or bladder may heal over time, and serious problems may be prevented.

Where can I find more information?

Having a blunt injury to the kidneys, ureters, or bladder may be hard. You and those close to you may feel scared, sad, or angry. These are normal feelings. Contact the following for more information:

  • American College of Surgeons
    633 N. Saint Clair St.
    Chicago , IL 606113211
    Phone: 1- 312 - 2025000
    Phone: 1- 800 - 6214111
    Web Address: http://www.facs.org

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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