• Chih-Yuan Fu, Shih-Chi Wu, Ray-Jade Chen, Yung-Fang Chen, Yu-Chun Wang, Ping-Kuei Chung, Hung-Chang Huang, Jui-Chien Huang, and Chih-Wei Lu.
• Trauma and Emergency Center, China Medical University Hospital, Taichung, Taiwan.
• Am. J. Surg. 2010 Feb 1;199(2):154-9.

BackgroundAngioembolization is an effective adjunct in the management of high-grade renal injuries not surgically treated. However, in some cases, the bleeding may stop spontaneously, without the need for embolization. The aim of this study was to define the characteristics of patients who need angioembolization for high-grade blunt renal injuries (BRIs).MethodsPatients with BRIs between January 2004 and May 2008 were retrospectively reviewed. Patients with contrast extravasation on computed tomographic scans who then underwent angiography were enrolled. Demographics, injury severity scores, abbreviated injury scale scores, amounts of blood transfused, and need for angioembolization were analyzed.ResultsTwenty-six patients were enrolled. Patients with discontinuity of Gerota's fascia and pararenal hematoma expansion in BRIs required angioembolization at a higher rate. Furthermore, these patients displayed higher injury severity scores and abbreviated injury scale scores. Five patients experienced complications.ConclusionsIn patients with BRIs, discontinuity of Gerota's fascia and pararenal hematoma expansion seemed to be associated with the need for angioembolization. Early angioembolization should be considered in patients with severe associated trauma with BRIs.Copyright 2010 Elsevier Inc. All rights reserved.

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