“Aman”
Posterior: Vertebra,costae,otot,lemak
perirenal
Anterior: organ intraperitoneal
Mode injury
Trauma langsung
Trauma tumpul (blunt) hebat
Trauma tajam
Trauma tembak
14 13
12
10
8 Blunt(KLL)
6 non KLL
5
Tajam
4 tembak
2
2 1
0
data RS Kariadi 1999 s/d 2006
(n=21)
Mode injury
Trauma tak langsung
Jatuh dari ketinggian:contracoup
Lesi pedikel
Preexisting anomali
Hydronephrosis ec BSK
Kapan curiga trauma ginjal?
Jejas di flank
Massa di flank
Hematuria
Fraktur costae
Fractur prosesus transversal
12
12
jejas di flank
10
9
masa di flank
8
6 gross hematuria
4 microskopis
4
hematuria
2 2 fraktur
2
0
Diagnostik
ABC trauma
Fast
Rontgen: IVU 5-10 menit
CT scan
6
6
3 positif
2 negatif
2
0
USG (Fast)
4
4
3.5
3
2.5 2
2 positif
negatif
1.5
1
0.5
0
IVP
3
3
2.5
1.5 positif
negatif
1
0.5
0
ct scan
16
16
14
12 hematuria
10
10
Dx(Fast,IVP,CT)
8
positif
6 Dx negatif
4
2
2
0
Grade I
•Sonografi
•CTscan
Psoas line
menghilang
IVP spastik
deformitas
Grade II
Laserasi parenkim<
1cm
Grade III
• Laserasi > 1cm
Grade IV
Laserasi dalam
Robekan PCS
Extravasasi kontras
masive
Grade V
Laserasi hebat
multiple
Hematom
retroperitoneal;
bulging
Grade V
Hematom retro
peritoneal massive
Bulging pulsating
6 6
4 grade 1
3 grade 2
3
grade 3
2 grade 4
2
grade 5
1 1
1
0
RS kariadi 1999 s/d 2006 (n=21)
Penatalaksanaan terapi
Grade I-II
90%
KONSERVATIF
Penatalaksanaan terapi
Trauma mayor
gradeIII-IV-V
Life saving
Preservasi ginjal