Perirenal Hematoma Secondary to Renal Rupture with Concurrent Splenic Rupture in a Twelve-Week-Old Boerbeol Puppy: A Case Report
The dog kidneys are elongated and are located retroperitonealy between the thirteen thoracic vertebrae and the third lumber vertebrae. The right kidney is usually more cranial than the left (Feeney and Johnston, 2007). Each kidney consists of an outer cortex and an inner medulla which projects into the pelvis. The kidney receives approximately twenty percent of the cardiac output through the renal arteries.
Renal injury is observed in about ten percent of cases of abdominal injury in humans (Razali et al., 2010). However, the exact incidence of renal injury in dogs is unknown. Majority of renal injuries are attributable to blunt trauma, while the rest are due to penetrating injuries, commonly gunshot wound and stab wounds (Kawashima et al., 2001; McAninch and Santucci, 2002). Renal injuries from blunt trauma usually occur as a consequence of a direct blow to the flank or from rapid deceleration (Razali et al., 2010). A direct blow will crush the kidney, causing a laceration or lacerations of the renal parenchyma and resulting in a subcapsular, intrarenal or perinephric hematoma (Dunnick et al., 2001).
The development of perirenal haematoma is rare and primarily the result of trauma, malignancy, or a connective tissue disease (Pavel et al., 2008). Infrequently, persistent or mild trauma can cause severe perirenal haematoma resulting in abdominal pain, hematuria and shock. In humans, kidney injury is common with falls and automobile accidents; however there is dearth of information of the causes of kidney rupture in dogs.
In veterinary patient, trauma and neoplasia have been recognized as the two most common causes of haemoperitoneum (Vinayak & Krahwinkel, 2004). Vehicular trauma has reportedly caused intraabdominal injury in 6.3 – 13 percent of injured animals (Brockman et al., 2000). The liver, spleen, kidneys and major vessels are the commonly affected structures, while the liver and the spleen are the most likely sources of severe haemorrhage (Fossum, 1997). Blunt trauma to the spleen and liver can involve a delay of up to three hours or more before signs of shock will develop (Vinayak & Krahwinkel, 2004). This report presents a case of severe haemoperitoneum from splenic laceration and perirenal hematoma secondary to renal rupture in a twelve week old Boerboel puppy after reportedly falling from a height.