-
- C D Goff and G R Collin.
- Department of Surgery, Carilion Roanoke Memorial Hospital, Virginia 24014, USA.
- Am Surg. 1998 Mar 1; 64 (3): 226-30.
AbstractAppropriate management of renal trauma is controversial. Successful outcome and long term complication rates are not well defined. In an effort to evaluate management options, outcomes, and complications of renal injuries, we conducted a retrospective review of all trauma patients admitted to the trauma service from January 7, 1989 through August 31, 1995. Inpatient and outpatient charts were reviewed for type and mechanism of injury, radiologic studies utilized, method of treatment, and short and long term complications. Fifty-five patients were identified with renal injuries. Most injuries were parenchymal injuries due to blunt trauma. Only nine patients with renal artery injuries and four patients with collecting system injuries were identified. CT scan was the most commonly used study to identify renal injuries. All nine renal artery injuries were due to blunt trauma and were initially diagnosed by CT scan. Six were confirmed with arteriogram, and two with renal scans. Of the seven patients seen in follow-up (average 153 days), there were three complications: one patient with small bowel obstruction and two patients with hypertension. Among the 47 patients with parenchymal injuries, including 4 patients with collecting system injuries, there were 2 with complications: an intraoperative ureteral transection and a urinoma. Both complications were treated successfully with a ureteral stent. Five deaths occurred in the entire group; none were related to renal injury. Thirteen patients underwent laparotomy for associated injuries only. Eight patients underwent surgical treatment for their renal injury, including five nephrectomies. The nephrectomy rate among those patients who underwent laparotomy as part of their initial management was 20 per cent, versus 3 per cent for those patients initially managed nonoperatively. Thus, most renal injuries can be managed nonoperatively with a low incidence of complications. The incidence of long-term complications after renal artery injuries and the appropriate management of these patients deserves further study.
Notes
Knowledge, pearl, summary or comment to share?You can also include formatting, links, images and footnotes in your notes
- Simple formatting can be added to notes, such as
*italics*
,_underline_
or**bold**
. - Superscript can be denoted by
<sup>text</sup>
and subscript<sub>text</sub>
. - Numbered or bulleted lists can be created using either numbered lines
1. 2. 3.
, hyphens-
or asterisks*
. - Links can be included with:
[my link to pubmed](http://pubmed.com)
- Images can be included with:
![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
- For footnotes use
[^1](This is a footnote.)
inline. - Or use an inline reference
[^1]
to refer to a longer footnote elseweher in the document[^1]: This is a long footnote.
.