playing in the nationwide Football league (NFL) is like surviving a collection of auto wrecks, with each play and also hit potentially causing far-ranging injury. Many players absorb a tackle or block and also walk away, yet sometimes pressures align and also the human body breaks. For Andrew Luck, Indianapolis Colts quarterback, those forces aligned in the 4th quarter that the game versus the Denver Broncos, and also a punch to his ago when being tackled brought about a laceration the his kidney. He ongoing to complete the game, but that is a testimony for a mind fueled by the adrenaline that the case that deserve to overcome a body"s pain and also injury for a short duration of time.

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A straight blow to the ago most commonly reasons kidney injuries. The kidneys (there room usually two, one on each side) are situated in the flank, the area top top the side and back of the abdomen just listed below the ribs. The kidneys are suspended by two relationships to the rest of the body, the vascular pedicle that contains the arteries and veins that attach it to the aorta, and also the ureter, the drains urine right into the bladder. It is reasonably well protected by reduced ribs, muscles, and also fat the the body, yet blunt force can cause the kidney come bruise (contusion) or break (termed a laceration or a bursting favor a dropped watermelon). A kidney is divided into segment or poles so that each segment has actually its own blood supply and their pee drainage collects into the key ureter. This is helpful when the kidney is injured, since an injury come one component or segment does no doom the whole kidney.

The diagnosis the a kidney laceration can frequently be missed at first if there isn"t a high index of suspicion based upon the system of injury (usually a direct blow and also often because of car crashes or other significant trauma). It"s easier to recognize if the patient has gross blood in the urine, but sometimes, there are only a few red blood cell in the urinalysis seen under a microscope. There must be abdominal muscle pain or flank pain and also tenderness when the flank is palpated (felt by the health-care provider during a physics exam). Kidney injuries also cause nausea and also vomiting, and also without the story the injury, the diagnosis deserve to be missed. However, a CT scan of the abdomen deserve to visualize the kidney structures, including the arteries and blood supply, and also confirm a kidney laceration; periodically an aortogram is necessary to very closely examine the kidney"s blood supply.

There are selection of stages of kidney injury relying on how much damages it sustained. It can be as mild as a bruise that the kidney that causes minimal damages (stage 1) or the kidney deserve to be shattered and torn native its pedicle (stage 5). A lacerated kidney describes a literal meaning tear of the kidney tissue that may or might not cause urine to leak wherein it doesn"t belong.

Because the its wealthy blood supply, the kidney is responsible because that cleansing waste assets from the body. A shattered kidney have the right to be life-threatening and also might require emergency surgery. Often, though, treatment is watchful waiting as the body enables the kidney to heal itself. Surgical procedure is no much longer routine, and also patients with kidney injuries space treated through rest. If there is part bleeding, interventional radiology can clot off bleeding arteries and preserve the remaining uninjured kidney.

Healing is measured in weeks, and also if no surgery is required, the victim can return come a continuous life and also function. There are potential complications. Early difficulties after injury can include delayed bleeding (usually within the an initial two weeks), infections, and urine leakage exterior the kidney (urinomas). As well, hypertension may happen transiently since the kidney homes hormones and chemicals that assist control blood pressure. There room late complications wherein scarring resulted in by the damage causes urine to drainpipe abnormally, resulting in the kidney come swell and also stones to form. There have the right to be recurrent infection and delayed-onset high blood pressure. The average time to cure is around six weeks; with minor lacerations, healing may occur also faster. Significant lacerations that might require surgery will require much more time come heal.

Medicine is gradually learning that sometimes, if left to its own devices and listed the proper support, the body have the right to heal itself fairly well. The kidney is an organ that is a testament to that observation.

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median reviewed by Michael Wolff, MD; American plank of UrologyREFERENCE:Morey, A.F., et al. "Urotrauma: AUA Guideline." J Urol 192.2 Aug. 2014.
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