Table of ContentsView AllTable of ContentsCausesGradingSymptomsDiagnosisTreatmentWhen to Get Help
Table of ContentsView All
View All
Table of Contents
Causes
Grading
Symptoms
Diagnosis
Treatment
When to Get Help
A kidney laceration is an injury in which a tear in the kidney tissue might lead to bleeding or leaking of urine into the abdominal cavity. The blood or urine collects in a space called theretroperitoneum, which is behind the peritoneum, where your bowels are located. Lacerated kidneys are often associated with high-energy trauma, such as falls from heights and traffic accidents.
Kidney injuries, also known as renal trauma, account for 1% to 5% of all traumatic injuries that are severe enough to require treatment at a trauma center.The severity of a kidney laceration ranges from a bruised kidney to a kidney that has shattered, the latter of which requiresemergency surgery.
This article explains what a lacerated kidney is, how it can happen, and what it feels like. It also discusses grading for kidney laceration severity, along with how kidney lacerations are treated.
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Causes of Kidney Lacerations
Lacerated kidneys can occur from blunt trauma, which is when the body collides with an object that does not enter the body (such as a steering wheel after a car crash). However, they can also occur from penetrating trauma, which is when an object does enter the body (such as a knife or bullet).
Symptoms of Internal Bleeding
Types of Kidney Injuries
Most people with low grade kidney lacerations can resume normal mobility and sporting activities within two to six weeks. For more severe kidney injuries, it can take up to 12 months to fully recover.
Symptoms of Kidney Lacerations
Kidney lacerations don’t just happen, so there has to be some sort ofmechanism of injury. In addition to a history of trauma, there are several symptoms of kidney laceration:
Blood in the urineis a telltale sign of kidney injury, but there could still be a kidney injury if you don’t see blood in the urine or any other symptoms at all. The blood might be microscopic or absent altogether.
Diagnosing Kidney Lacerations
The diagnosis of a renal injury is done through a detailed history and physical. Labs and imaging will be ordered to evaluate the injury and to help plan for treatment. Labs may include checking urine for blood, hemoglobin, and hematocrit to check for blood loss, and renal function tests to check functioning of the kidneys.
The standard imaging is a CT Urogram which is a CAT scan done with IV contrast and delayed films to help visualize the kidney in its entirety.
Kidney Lacerations Treatments
Based on the findings from the workup you may be sent home or admitted to the hospital for observation with frequent lab checks, strict bed rest, and close monitoring of vital signs.
If you are sent home after observation there may be a plan to check repeat imaging in the future. If your injury is high-grade, you may require emergency surgery to repair or remove the kidney.
When to See a Healthcare Provider
If you suspect a kidney injury, you should go to the emergency department for evaluation. If you feel dizzy or weak,call 911rather than drive yourself to the hospital.
Anytime you see blood in the urine following an injury, even if it doesn’t seem like your abdomen was involved, you should see a doctor immediately. Note that bleeding may not occur right away.
If you are feeling pain in the flank, tenderness in this area, or lightheadedness when you stand, you should see a healthcare provider immediately (even if the injuring accident was several weeks prior).
Summary
Kidney lacerations are a type of kidney injury that ranges from a bruised kidney, to a kidney that is leaking urine or has completely shattered. Kidney lacerations are typically the result of very high-energy traumatic injuries, like traffic accidents. With a lacerated kidney, you may experience flank pain, dizziness, or blood in your urine, all of which are should be treated with immediate medical attention. Fortunately, most lacerated kidneys heal with time and rest, although more severely lacerated kidneys may require emergency surgery.
Causes of Kidney Pain
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sugimoto T, Ono Y, Ueshima E, Matsushiro K, Yamada I, Kotani J.Severe left kidney laceration after minor fall in a patient with lumbar spine scoliosis.Acute Med Surg. 2023 Dec;10(1):e816. doi:10.1002/ams2.816Salcedo A, Ordoñez C, Parra M, et al.Damage control for renal trauma: The more conservative the surgeon, better for the kidney.Colomb Med (Cali). 2021 Jun;52(2):e4094682. doi:10.25100/cm.v52i2.4682The American Association for the Surgery of Trauma.Injury scoring scale.Hoen L, O’Kelly F, Lammers R, et al.Mobility and sporting activity after renal trauma: A survey regarding best clinical practice during the recovery stage.Pediatr Urol. 2024 Jan;183(1):199-203. doi:10.1016/j.urology.2023.09.030Mount Sinai.Injury - kidney and ureter.Additional ReadingHaller JA, Papa P, Drugas G, Colombani P.Nonoperative management of solid organ injuries in children. Is it safe?.Ann Surg. 1994;219(6):625-8; discussion 628-31.Malaeb B, Figler B, Wessells H, Voelzke BB. Should blunt segmental vascular renal injuries be considered an American Association for the Surgery of Trauma Grade 4 renal injury?.J Trauma Acute Care Surg. 2014;76(2):484-7. DOI:10.1097/TA.0b013e3182aa2db4Shoobridge JJ, Corcoran NM, Martin KA, Koukounaras J, Royce PL, Bultitude MF.Contemporary management of renal trauma.Rev Urol. 2011;13(2):65-72.van Hensbroek PB, van Ooijen M, Lamers AB, Ponsen KJ, Goslings JC.Abdominal injuries after high falls: high incidence and increased mortality.Acta Chir Belg. 2013 May-Jun;113(3):170-4.Wendler JJ, Jürgens J, Schostak M, Liehr UB. Traumatically shattered kidney without urine extravasation or vascular amputation.BMJ Case Rep. 2015. DOI:10.1136/bcr-2014-208303
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sugimoto T, Ono Y, Ueshima E, Matsushiro K, Yamada I, Kotani J.Severe left kidney laceration after minor fall in a patient with lumbar spine scoliosis.Acute Med Surg. 2023 Dec;10(1):e816. doi:10.1002/ams2.816Salcedo A, Ordoñez C, Parra M, et al.Damage control for renal trauma: The more conservative the surgeon, better for the kidney.Colomb Med (Cali). 2021 Jun;52(2):e4094682. doi:10.25100/cm.v52i2.4682The American Association for the Surgery of Trauma.Injury scoring scale.Hoen L, O’Kelly F, Lammers R, et al.Mobility and sporting activity after renal trauma: A survey regarding best clinical practice during the recovery stage.Pediatr Urol. 2024 Jan;183(1):199-203. doi:10.1016/j.urology.2023.09.030Mount Sinai.Injury - kidney and ureter.Additional ReadingHaller JA, Papa P, Drugas G, Colombani P.Nonoperative management of solid organ injuries in children. Is it safe?.Ann Surg. 1994;219(6):625-8; discussion 628-31.Malaeb B, Figler B, Wessells H, Voelzke BB. Should blunt segmental vascular renal injuries be considered an American Association for the Surgery of Trauma Grade 4 renal injury?.J Trauma Acute Care Surg. 2014;76(2):484-7. DOI:10.1097/TA.0b013e3182aa2db4Shoobridge JJ, Corcoran NM, Martin KA, Koukounaras J, Royce PL, Bultitude MF.Contemporary management of renal trauma.Rev Urol. 2011;13(2):65-72.van Hensbroek PB, van Ooijen M, Lamers AB, Ponsen KJ, Goslings JC.Abdominal injuries after high falls: high incidence and increased mortality.Acta Chir Belg. 2013 May-Jun;113(3):170-4.Wendler JJ, Jürgens J, Schostak M, Liehr UB. Traumatically shattered kidney without urine extravasation or vascular amputation.BMJ Case Rep. 2015. DOI:10.1136/bcr-2014-208303
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Sugimoto T, Ono Y, Ueshima E, Matsushiro K, Yamada I, Kotani J.Severe left kidney laceration after minor fall in a patient with lumbar spine scoliosis.Acute Med Surg. 2023 Dec;10(1):e816. doi:10.1002/ams2.816Salcedo A, Ordoñez C, Parra M, et al.Damage control for renal trauma: The more conservative the surgeon, better for the kidney.Colomb Med (Cali). 2021 Jun;52(2):e4094682. doi:10.25100/cm.v52i2.4682The American Association for the Surgery of Trauma.Injury scoring scale.Hoen L, O’Kelly F, Lammers R, et al.Mobility and sporting activity after renal trauma: A survey regarding best clinical practice during the recovery stage.Pediatr Urol. 2024 Jan;183(1):199-203. doi:10.1016/j.urology.2023.09.030Mount Sinai.Injury - kidney and ureter.
Sugimoto T, Ono Y, Ueshima E, Matsushiro K, Yamada I, Kotani J.Severe left kidney laceration after minor fall in a patient with lumbar spine scoliosis.Acute Med Surg. 2023 Dec;10(1):e816. doi:10.1002/ams2.816
Salcedo A, Ordoñez C, Parra M, et al.Damage control for renal trauma: The more conservative the surgeon, better for the kidney.Colomb Med (Cali). 2021 Jun;52(2):e4094682. doi:10.25100/cm.v52i2.4682
The American Association for the Surgery of Trauma.Injury scoring scale.
Hoen L, O’Kelly F, Lammers R, et al.Mobility and sporting activity after renal trauma: A survey regarding best clinical practice during the recovery stage.Pediatr Urol. 2024 Jan;183(1):199-203. doi:10.1016/j.urology.2023.09.030
Mount Sinai.Injury - kidney and ureter.
Haller JA, Papa P, Drugas G, Colombani P.Nonoperative management of solid organ injuries in children. Is it safe?.Ann Surg. 1994;219(6):625-8; discussion 628-31.Malaeb B, Figler B, Wessells H, Voelzke BB. Should blunt segmental vascular renal injuries be considered an American Association for the Surgery of Trauma Grade 4 renal injury?.J Trauma Acute Care Surg. 2014;76(2):484-7. DOI:10.1097/TA.0b013e3182aa2db4Shoobridge JJ, Corcoran NM, Martin KA, Koukounaras J, Royce PL, Bultitude MF.Contemporary management of renal trauma.Rev Urol. 2011;13(2):65-72.van Hensbroek PB, van Ooijen M, Lamers AB, Ponsen KJ, Goslings JC.Abdominal injuries after high falls: high incidence and increased mortality.Acta Chir Belg. 2013 May-Jun;113(3):170-4.Wendler JJ, Jürgens J, Schostak M, Liehr UB. Traumatically shattered kidney without urine extravasation or vascular amputation.BMJ Case Rep. 2015. DOI:10.1136/bcr-2014-208303
Haller JA, Papa P, Drugas G, Colombani P.Nonoperative management of solid organ injuries in children. Is it safe?.Ann Surg. 1994;219(6):625-8; discussion 628-31.
Malaeb B, Figler B, Wessells H, Voelzke BB. Should blunt segmental vascular renal injuries be considered an American Association for the Surgery of Trauma Grade 4 renal injury?.J Trauma Acute Care Surg. 2014;76(2):484-7. DOI:10.1097/TA.0b013e3182aa2db4
Shoobridge JJ, Corcoran NM, Martin KA, Koukounaras J, Royce PL, Bultitude MF.Contemporary management of renal trauma.Rev Urol. 2011;13(2):65-72.
van Hensbroek PB, van Ooijen M, Lamers AB, Ponsen KJ, Goslings JC.Abdominal injuries after high falls: high incidence and increased mortality.Acta Chir Belg. 2013 May-Jun;113(3):170-4.
Wendler JJ, Jürgens J, Schostak M, Liehr UB. Traumatically shattered kidney without urine extravasation or vascular amputation.BMJ Case Rep. 2015. DOI:10.1136/bcr-2014-208303
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