• Urology · May 2010

    Genitourinary injuries in pediatric all-terrain vehicle trauma--a mechanistic relationship?

    • Chase Kluemper, Aimee Rogers, Mary Fallat, and Andrew C Bernard.
    • Department of Behavioral Science, University of Kentucky, Lexington, Kentucky 40503, USA. chasekluemper@uky.edu
    • Urology. 2010 May 1; 75 (5): 1162-4.

    ObjectivesTo define and discuss the characteristics of all-terrain vehicle (ATV)-related pediatric (<16 years) genitourinary (GU) trauma. ATV collisions represent a significant and growing portion of trauma cases in rural America. ATV-related renal injuries have been reported in adults but a comprehensive review of ATV-related pediatric GU trauma cases is needed.MethodsA retrospective analysis of admissions to 2 trauma centers in Kentucky between 1997 and 2007 was performed, identifying youth who presented with ATV-related GU injuries. Demographics, injury data, and treatment records for children with GU trauma in this study population were recorded and analyzed.ResultsA total of 429 youth were admitted after ATV injuries during the study period. Of these, 13 (7 boys, 6 girls) had GU injuries (3%) and the average age was 10.7 years. Of 13 patients, 12 (92%) were unhelmeted and the mean injury severity score was 10.3. Twelve of 13 (92%) suffered renal injuries (7 contusions, 5 lacerations) and 1 (8%) had an extraperitoneal bladder rupture. Renal lacerations were grade I-V. Hematuria was very common (10/12, 83%) and intensive care unit care was required in 5 of 12 (42%) patients. Mean length of stay was 5 days and 12 of 13 (92%) were discharged home. The most common associated injury was splenic laceration (4/13, 31%).ConclusionsGU trauma in ATV-injured youth is uncommon but when it occurs, renal injuries predominate. Most present with hematuria. Prevalence of renal trauma among GU injuries in children suggests a unique injury mechanism (crush during ATV roll or strike of the handlebars) and more study of injury mechanics is warranted. A high index of suspicion is warranted in evaluating these children.Copyright 2010 Elsevier Inc. All rights reserved.

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