| Crush Syndrome (Traumatic Anuria) |
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| Written by Administrator | |||||||||
| Thursday, 10 December 2009 10:02 | |||||||||
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Crush Syndrome (Traumatic Anuria) ¦Definition: A case of renal shutdown following crush or compression injuries or neglected prolonged tourniquet . ¦Pathogenesis: The renal shutdown occurs due to: a- Compression injury ® Muscle ischaemia and damage ® liberation of acid myohaematin which circulate in blood till reach the kidney where it is percipitated on renal tubules blocking it . b- The accompanying shock ® Renal ischaemia ® Acute tubular necrosis ¦Clinical Picture: 1- The crushed limb : Swollen with paralyzed muscles & absent pulse. 2- 2-3 days later:oliguria appears. Urine is characteristically highly acidic containing acid myohaematin crystals. 3- If the case is managed properly the oliguria will change to polyuria then spontaneous recovery will occur. ¦Treatment : (1) Correction of shock by blood, plasma & fluids . (see before) (2) Alkalinization of urine by Na Co3 or Na lactate . (3) If renal failure develops manage as a case of acute renal failure. SOURCE: Prof. AYMAN SALEM'S BOOK Copyright: (Vascular Society of Egypt ) & (Medical Educational web) Not to be reproduced without permission of Vascular Society of Egypt
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