The kidneys are situated in the posterior part of the abdomen on either side of the vertebral column behind the peritoneum. The right kidney is usually slightly lower than the left. The posterior surface and upper portion of the right kidney rest on the 12 th rib; the left kidney usually rests on the 11th and 12 th ribs. The anterior surface of the right kidney is in contact with the right adrenal gland, liver, and the right colic flexure. The anterior surface of the left kidney is in contact with the left adrenal gland, stomach, spleen, jejunum, colon, and, medially, the pancreas.
Spontaneous rupture of the normal kidney does not occur. Blunt force injuries to the kidney are uncommon. They are usually seen following motor vehicle accidents or falls from great heights when there is massive blunt force trauma to the abdominal cavity. Blunt force applied to the flank may crush the kidney between the abdominal wall and the lumbar vertebrae. The most common injury to a kidney is a contusion. Aside from contusions, the majority of injuries to the kidney are small transverse lacerations beneath an intact capsule with minimal hemorrhage. Injuries producing massive lacerations of the kidneys up to fragmentation are uncommon and are associated with massive injury to the other abdominal organs.
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