Blunt Renal Trauma in a Patient With a Congenital Solitary Kidney: A Case Report
Mamadou Beye,
Binta Sakho,
Sidy Mohamed A. Fall,
Babacar Mbengue,
Thieyacine Mouhamet Ndiaye,
Dialtabé Ibrahima G. Ba
Introduction: Blunt renal trauma in a patient with a congenital solitary kidney is a rare but potentially
life-threatening clinical scenario. Conservative management has progressively become the standard of
care for blunt renal trauma in hemodynamically stable patients, irrespective of injury grade.
Case Description: A 25-year-old previously healthy man was admitted to the emergency department of
Diourbel Regional Hospital after a horse-kick to the right lumbar region. He reported severe right-sided
lumbar pain associated with gross hematuria and clots, and was hemodynamically stable on admission.
Abdominopelvic CT revealed a deep parenchymal laceration measuring more than 4 cm in the midinferior
portion of the right kidney, with subcapsular and perirenal hematoma but without contrast
extravasation, classified as American Association for the Surgery of Trauma (AAST) grade III. CT also
incidentally demonstrated complete absence of the left kidney, consistent with congenital renal agenesis.
Given hemodynamic stability and the absence of urinary extravasation or vascular injury, conservative
management was elected. At 3-month follow-up, the patient was asymptomatic, no complications were
observed, and renal function was preserved.
Conclusions: Conservative management of blunt renal trauma on a solitary kidney is feasible and
effective in hemodynamically stable patients, regardless of AAST injury grade, in line with current
guidelines. Structured long-term nephrology follow-up is mandatory in this population because of the
cumulative risks of post-traumatic hypertension, proteinuria, and chronic kidney disease.
