Paediatric Surgery (Ukraine). 2026. 2(91): 136-141. doi: 10.15574/PS.2026.2(91).136141
Ksonz I. V.¹, Voloshyn O. M.², Hrytsenko Ie. M.¹, Voloshyna V. M.¹, Ksonz V. I.^3
1Poltava State Medical University, Ukraine
²ME «Children’s City Clinical Hospital of Poltava City Council», Ukraine
³MNE "Kyiv City Medical Center", Ukraine

For citation: Ksonz IV, Voloshyn OM, Hrytsenko IeM. Voloshyna VM, Ksonz VI. (2026). Management of kidney injury in children: a clinical case analysis and 20-year experience. Paediatric Surgery (Ukraine). 2(91): 136-141. doi: 10.15574/PS.2026.2(91).136141.
Article received: Jan 29, 2026. Accepted for publication: Jun 15, 2026.

Over the past decades, the treatment of kidney injury in children has shifted towards a conservative approach in haemodynamically stable patients.
Aim – to analyze our own results of treating children with kidney injuries of varying degrees of severity, and, using a clinical case as an example, to evaluate the possibilities of conservative treatment in cases of severe kidney injury.
The results of treatment of 60 patients who were hospitalized with a confirmed diagnosis of kidney injury were analyzed. The main imaging methods were ultrasound (US) and contrast-enhanced computed tomography (CT). Conservative treatment was effective in all cases of grades I-III injuries. Of the 13 cases of severe kidney injury, 6 (10.0%) patients required surgery within the first 72 hours, and 2 (3.3%) underwent a nephrectomy.
Clinical case. Patient O., aged 13, was hospitalized with the diagnosis: ‘Closed abdominal trauma. Grade IV rupture and fragmentation of the middle third of the right kidney. Right kidney haematoma. Right-sided retroperitoneal urohaematoma’. The child’s haemodynamic stability was the basis for choosing conservative treatment. On day 15, percutaneous drainage of the large haematoma was performed. Healing of the kidney with preserved function was confirmed by contrast-enhanced CT 12 months after the injury.
Conclusions. Modern imaging methods for examining patients with kidney trauma allow minimizing or even avoiding surgical intervention. In haemodynamically stable patients, regardless of the grade of kidney damage, conservative management and delaying surgery are the priorities. If surgery is necessary in the case of perirenal haematomas and urohaematomas, preference is given to minimally invasive percutaneous drainage methods.
The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution. Informed consent was obtained from the parents (or guardians) and children.
The authors declare no conflicts of interest.
Keywords: kidney injury, imaging methods, conservative treatment, children.

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