INTRODUCTION To report the management and outcome of one case of pediatric patient sustaining high-grade blunt renal trauma. We present and discuss the clinical characteristics and radiologic features of the patient. PATIENTS AND METHODS A 10 years old child was admitted for serious blunt renal trauma formed a huge urinoma in the right renal after injury gradually in 2018. We treated the patient with synchronous percutaneous nephrostomy drainage and retrograde ureteral catheterization. A retrospective review was performed of this case, including the clinical features, imaging studies and short-term follow-up. A literature review was also performed to highlight the principals of diagnosis and treatment of severe blunt renal trauma in children. RESULTS After drainage, the symptoms of abdominal distension gradually disappeared, and the physical examination shows that the abdomen gradually reduced to normal. The huge urinoma was cured by synchronous drainge. No complications occurred in short-term follow-up. COMMENTS The choice of surgical treatment is based on the degree and location of renal trauma. Grade IV injuries are a heterogeneous group and management should be tailored to the patient, especially among pediatric patients. Persistent urinary extravasation and/or symptomatic urinoma is a common complication of high-grade renal trauma, which will be amenable to ureteral stent placement or percutaneous drainage. For huge urinoma, synchronous percutaneous nephrostomy drainage and retrograde ureteral catheterization can relieve symptoms quickly.

中文翻译：

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儿童严重肾脏创伤的诊断挑战：病例报告和文献复习。

引言1例小儿高级别钝性肾脏外伤患者的治疗和结果。我们介绍并讨论患者的临床特征和放射学特征。患者与方法一名10岁的孩子因严重钝性肾损伤入院，并于2018年逐渐受伤后在右肾形成了巨大的尿路上皮瘤。我们对患者进行了同步经皮肾造瘘术和逆行输尿管导管治疗。对该病例进行了回顾性审查，包括临床特征，影像学研究和短期随访。还进行了文献综述，以强调儿童严重钝性肾损伤的诊断和治疗原则。结果引流后，腹胀症状逐渐消失，体格检查表明腹部逐渐恢复正常。巨大的尿液瘤通过同步引流术治愈。短期随访中无并发症发生。评论手术治疗的选择取决于肾脏创伤的程度和位置。IV级损伤是一个异类，应根据患者（尤其是小儿患者）量身定制治疗方案。持续性尿道外渗和/或症状性尿路瘤是严重肾脏损伤的常见并发症，可通过输尿管支架置入或经皮引流进行治疗。对于巨大的尿液瘤，同步经皮肾造瘘术引流和逆行输尿管导管插入术可快速缓解症状。短期随访中无并发症发生。评论手术治疗的选择取决于肾脏创伤的程度和位置。IV级损伤是一个异类，应根据患者（尤其是小儿患者）量身定制治疗方案。持续性尿道外渗和/或症状性尿路瘤是严重肾脏损伤的常见并发症，可通过输尿管支架置入或经皮引流进行治疗。对于巨大的尿液瘤，同步经皮肾造瘘术引流和逆行输尿管导管插入术可快速缓解症状。短期随访中无并发症发生。评论手术治疗的选择取决于肾脏创伤的程度和位置。IV级损伤是一个异类，应根据患者（尤其是小儿患者）量身定制治疗方案。持续性尿道外渗和/或症状性尿路瘤是严重肾脏损伤的常见并发症，可通过输尿管支架置入或经皮引流进行治疗。对于巨大的尿液瘤，同步经皮肾造瘘术引流和逆行输尿管导管插入术可快速缓解症状。特别是在儿科患者中。持续性尿道外渗和/或症状性尿路瘤是严重肾脏损伤的常见并发症，可通过输尿管支架置入或经皮引流进行治疗。对于巨大的尿液瘤，同步经皮肾造瘘术引流和逆行输尿管导管插入术可快速缓解症状。特别是在儿科患者中。持续性尿道外渗和/或症状性尿路瘤是严重肾脏损伤的常见并发症，可通过输尿管支架置入或经皮引流进行治疗。对于巨大的尿路瘤，同步经皮肾造瘘术引流和逆行输尿管导管插入术可快速缓解症状。