Diagnosis and Management of Renal Trauma in Two University Teaching Hospitals in Burkina Faso

Introduction: Renal trauma, resulting from external mechanical injury, impacts both renal and vital prognosis, particularly in severe cases. In Africa, the predominant etiologies are road traffic accidents and falls. This study describes the diagnostic and therapeutic profile of renal trauma in two university teaching hospitals in Burkina Faso. Methods: A descriptive retrospective study was conducted over 5 years (2019-2023), including all patients managed for renal trauma. Sociodemographic, clinical, paraclinical, and therapeutic data were analyzed. Results: Forty cases were collected. The mean age was 25.5 years, with a male predominance (85%). Road traffic accidents accounted for 75% of causes. Clinically, lumbar pain (92.5%) and hematuria (77.7%) were common. All patients underwent CT urography (CTU), classifying lesions according to the AAST scale: grades IV (50%) and III (35%) predominated. Conservative management was applied in 95% of patients, including bed rest, analgesia, antibiotic therapy (57.5%), and blood transfusion (27.5%). Nephrectomy (5%) was required for hemodynamic instability or persistent life-threatening hematuria. The outcome was favorable for the majority, with complications (persistent urinoma/hematoma, abscess) in a few high-grade patients. Discussion: The patient profile (young active males) and etiology (road traffic injuries) are consistent with regional data. CTU is established as the key examination for assessment. The high rate of conservative management, even for grades III-IV, confirms this strategy as the standard for stable patients, allowing preservation of nephron mass without increased morbidity. Nephrectomy remains exceptional. Loss to follow-up limits the evaluation of long-term outcomes. Conclusion: Renal trauma in Burkina Faso primarily affects young males involved in road traffic accidents. Its management, largely conservative thanks to the contribution of CTU, is effective. Road safety prevention constitutes a major focus for reducing the incidence of these injuries.