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Figure 10-2. Location of the liver, spleen, and kidneys in relation to the lower ribs posteriorly
A ruptured kidney is usually manifested by a history of a blow in the back or flank;
pain,tenderness,anddiscolorationatthepointofinjury;andbloodintheurine.Thekidney
is enveloped in a tough, fibrous sheath, and bleeding from kidney injuries usually stops
spontaneously; rarely is an immediate operation necessary. However, the presence of large
amounts of blood in the urine for more than six hours and signs of shock are indications
that bleeding has assumed dangerous proportions. Such an individual should be treated for
shock and evacuated as rapidly as possible. If bleeding from a damaged kidney stops, the
individual must still wait at least ten days before resuming vigorous activity since delayed
bleeding may occur.
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