- Traumatic tubular necrosis may occur in cases of trauma to the limbs in which necrosis of the muscle occurs, which may be due to ischemia of direct compression.
- It results from severe crushing of the muscles, especially those that involve the lower limbs
- Eg: under fallen masonry, industrial and vehicular accidents, etc..
- In traffic accidents necrosis of muscle may occur without any prolonged crushing injury. Death usually occurs in one or two weeks after injury
- Crush syndrome is also seen in extensive burns and certain poisons eg: Mercuric salts or carbon tetrachloride
- The cause is obscure but may involve the juxtaglomerular apparatus and the renin-angiotensin system and disseminated intravascular coagulation effects on the glomeruli. These are non-specific gross changes in the Kidney.
- Reveals degeneration and necrosis of focal portions of distal part of Henle's loop and the DCT cellular infiltration is seen in the interstitial tissues around the degenerated and necrosed tubules.
- The distal tubule and collecting tubule contains cast of haem compounds.
- The glomeruli and PCT appears normal.
MICROSCOPIC EXAMINATION:
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