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Urology

What are the Symptoms of a Bruised Kidney? A Guide to Kidney Bruises

Dr. Joe Pazona

You’re lined up in the slot. Press coverage. You fight off the defender at the line of scrimmage, run a crossing route, the ball’s a little high, you jump and make the catch with outstretched hands, then . . . smack! A defender hits you right in the ribs.

After catching your breath that dull ache in your upper abdomen starts. You don’t feel so great. Someone helps you off the field and you grab a seat. After 10 minutes you’re still not right and call it a day.

When you arrive home, your wife of 20 years says, asks about your “football game” with a hint of sarcasm. At 46 years old, you’re questioning your decision to join the local weekend warrior, “hey I thought this was supposed to be a flag football league.”

You grab a cold one from the fridge and hit the lazy boy with your laptop. You’re still not feeling great. As the pain intensifies, you recall Andrew Luck’s kidney laceration back in 2015 because he was on your last place fantasy football team.

Although to be clear, you are not Andrew Luck, you are in pain. How do you know if you’ve injured an internal organ? You dial up Dr. Google and ask “what are the symptoms of a bruised kidney?” They could be the following:

1. Worsening flank or abdominal pain

2. Blood in the urine

3. Systemic symptoms: dizziness, nausea/vomiting

That led you to us. The urology experts at VirtuCare. Let’s run through some questions (first and foremost why you’re playing in a rec football league in your 40’s) so you can determine if you have a bruised kidney . . . or just a muscle strain with a bruised ego.

Where are my kidneys?

In order to know if you’ve hurt something, it helps to know where the internal organ is located. The kidneys are two bean shaped organs located in your upper back. They are sandwiched between your back muscles, abdominal contents and lower ribs.

diagram of kidneys

How does a bruised kidney happen?

Each kidney is surrounded by a layer of fat further protecting them from trauma. As a result it takes a significant blow to the lower ribcage, upper abdomen or back area to bruise a kidney. Our football example above illustrates a less common cause for a bruised kidney (especially for those of us who consider post-COVID hugs to be the limit of our participation in contact sports).

Bruised kidneys usually occur with blunt trauma from a motor vehicle accident or serious fall. Often other internal organs are injured but not always. A penetrating trauma, god forbid, from a knife or gunshot, can also cause a bruised or even lacerated kidney.

Let’s dive into the potential symptoms so you can better assess if you need a 2nd cold one or a trip to the ER.

Symptoms of a bruised kidney

No symptoms

Due to its location in the body, a bruised kidney may not present with any symptoms. The trauma itself may have hurt upon impact, but a small bruise (aka hematoma) may not lead to any symptoms. In this case you won’t even know the kidney was bruised.

You took it like a champ and have nothing to worry about. Unless you start developing . . .

Worsening flank or abdominal pain

As a general rule, any internal pain that is constant, worsening and approaching severe, should require immediate medical attention. In the case of a bruised kidney, this would typically cause pain in the back, flank or upper abdomen. Diffuse abdominal pain may indicate more severe internal bleeding.

It’s time to get immediate help if this sounds like you.

Blood in the urine

As a general rule, hematuria (fancy doctor term for blood in the urine), always requires an evaluation with a urologist. The blood we are discussing in this case is visible to the eye. After a trauma, blood may be seen microscopically on a urine sample for some time.

Regardless, an evaluation with a urologist is in your future to see if the kidney is bruised or something else might be going on.

Systemic symptoms: dizziness, nausea/vomiting

After any trauma, including a bruised kidney, the body can go into shock. This causes a drop in blood pressure leading to feelings of nausea and “I’m going to pass out!”. In some cases, the shock is due to blood loss.

The kidney receives 1 liter of blood per minute! It’s no surprise then that a trauma to a kidney can cause significant blood loss.

Now if you’re still reading this and enjoying your beer, the likelihood of this scenario is low. But if you’re having nausea, lightheadedness, blood in the urine, and significant pain, then call 911 immediately.

How will I really know if my symptoms are caused by a bruised kidney?

This is not one of those times for a telemedicine visit with VirtuCare. You need an in-person evaluation ASAP. This is why we have emergency rooms.

In the ER they will start with vital signs and blood work. Next they will most likely perform an abdominal ultrasound or CT scan of the abdomen. Imaging is required to see if the kidney is bruised, and if it is, the severity of the injury. The severity of the injury will determine . . .

How do you treat a bruised kidney?

Lucky for you, most trauma of the kidney can be managed without an operation. In more minor cases, a discharge home with physical restrictions for a couple of days to weeks may be all that is necessary.

Sometimes an overnight stay in the hospital is required to make certain your blood levels are stable. We also want to monitor any blood in the urine so your bladder doesn’t get plugged up with clots. After discharge, you may be placed on strict bed rest until the blood in the urine resolves.

If you start requiring multiple blood transfusions or medicine to maintain your blood pressure, then an intervention is likely in your future. Sometimes this can be done via an embolization with an interventional radiologist, other times a surgery is necessary to stop the bleeding.

Conclusions: Symptoms of a Bruised Kidney

We hope that your 3 inch jump off the ground during flag football only left you with a muscle strain. But if you have any concerns at all, and you’re not certain what to do, then our experts at VirtuCare are here to help.

To be clear if you have any of the following symptoms please do not contact us, and instead go to your local ER or call 911:

  • Blood in the urine
  • Severe pain
  • Lightheadedness
  • Nausea or vomiting

 

If your symptoms are more mild, and fighting the crowd at your local ER doesn’t sound enticing at the moment, then maybe we can help. Our board-certified urologists are trained to provide you with expert care from the comfort of our home.

As a side benefit, we can chat about fantasy football. Although my team was abysmal last year, I’m hopeful that one of these years my 1st two draft picks won’t poop the bed. Or bruise their kidney and miss 8 weeks.

ABOUT THE AUTHOR

Dr. Joe Pazona

Dr. Joseph Pazona is the founder and President of VirtuCare, a telemedicine solution for connecting patients with physician experts. He can be reached at joe@myvirtucare.com.
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