Severe left kidney laceration after minor fall in a patient with lumbar spine scoliosis

• Published in: Acute medicine & surgery Vol. 10; no. 1; pp. e816 - n/a
• Main Authors: Sugimoto, Takashi, Ono, Yuko, Ueshima, Eisuke, Matsushiro, Keigo, Yamada, Isamu, Kotani, Joji
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.01.2023; John Wiley and Sons Inc; Wiley
• Subjects: Abdomen; Case Report; Cobb angle; fall; Kidneys; low‐impact injury; Medical imaging; Readership; selective arterial embolization; spinal curvature disorder; spinal curvature disorder; low‐impact injury; fall; selective arterial embolization; Cobb angle
• ISSN: 2052-8817; 2052-8817
• DOI: 10.1002/ams2.816

Background The kidneys are one of the organs most commonly affected by blunt trauma; however, the anatomical variations that predispose kidney injury are poorly understood. Case Presentation An 80‐year‐old Japanese woman with lumber scoliosis was brought to our hospital because of severe flank pain after a minor fall at home. Contrast‐enhanced computed tomography showed a severe left kidney laceration at the level of an acute angle in the vertebral column caused by scoliosis. Extravasation of contrast medium from the left renal artery branches was also noted. Selective arterial embolization achieved hemostasis. The patient was transferred to a rehabilitation facility without sequelae. Conclusion Patients with scoliosis could be at higher risk of severe kidney laceration because of intrusion of the vertebral column into the retroperitoneal space. Therefore, even after low‐impact trauma, active exploration for kidney injury could be warranted in patients with spinal curvature disorders. This case illustrates that patients with lumbar scoliosis could be at higher risk of severe kidney laceration. Protrusion of the lateral edges of a scoliotic lumbar spine into the retroperitoneal space could crush the kidney, even after a minor fall. Clinicians should be cautious when examining patients with lumbar spine scoliosis because even minor trauma, such as a fall, can result in severe kidney injury.