Journal of the Mississippi State Medical Association
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J Miss State Med Assoc · May 2010
Blunt renal trauma and the predictors of failure of non-operative management.
While non-operative management of renal trauma in selected patients is now an accepted management option, predictors of failure of this treatment strategy are still unclear. ⋯ Non-operative management of blunt renal injuries is successful in most cases. Patients with a high base deficit, ongoing transfusion requirements, and greater Injury Severity Scores have a higher likelihood of requiring operation, but these procedures most often are to address non-renal abdominal injuries. High-grade blunt renal injuries that are hemodynamically stable can be treated expectantly on an individual basis with close follow-up. Any patient with hemodynamic instability, renal pedicle injury, renal artery thrombosis, or urinary extravasation will likely require operative intervention.