• Bethany J Farr, Lindsey B Armstrong, Samuel C Barnett, and David P Mooney.
• Department of Surgery, Boston Children's Hospital, Fegan 3, 300 Longwood Avenue, Boston, MA, 02115, USA. Bethany.farr@childrens.harvard.edu.
• Eur J Trauma Emerg Surg. 2022 Feb 1; 48 (1): 173-178.

PurposeHigh-grade pediatric renal trauma may be associated with a urine leak and appropriate management remains unclear.MethodData on patients with a traumatic renal injury were retrieved from the trauma registry and data warehouse of a pediatric level 1 trauma center over a 15-year period. Demographics, diagnoses, imaging, interventions performed, and follow-up information on patients with a urine leak were analyzed.Results187 renal injuries were identified and 32 (17%) were high grade. There were 21 (11%) diagnoses of urine leak, comprising the study population. Leaks were identified 0-10 day post-injury. All patients underwent initial computerized tomography (CT); however, 10 (48%) lacked excretory-phase imaging, leading to repeat CT. Ten patients (48%) did not undergo an intervention for their leak, and 11 (52%) underwent at least one, most commonly stent placement (10). Comparing non-intervention and intervention groups: Injury Severity Score (ISS) and initial Shock Index - Pediatric Adjusted (SIPA) were similar, but there was variation in antibiotic prophylaxis (60% vs 100%), average number of imaging studies performed (6.4 vs 8.1) and average length of hospital stay in days (7.7 vs 8.6).ConclusionTraumatic urine leaks are unusual, and half require no intervention. Management is variable and the development of care guidelines could decrease variation. Given their infrequency a multi-institutional study is required to generate sufficient patient volume.© 2020. Springer-Verlag GmbH Germany, part of Springer Nature.

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