Renal Trauma: Experience with 258 Cases

Nation, Earl F.; Massey, Ben D.

doi:10.1016/s0022-5347(17)64646-9

Cited by 54 publications

(7 citation statements)

References 4 publications

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“…Patients admitted to one hospital with penetrating abdominal injuries were found to have renal trauma in 4–8%[27]. In another study, penetrating injuries comprised 19% of county hospital renal trauma cases and only 1.2% of private hospital cases [28]. Overall, 18.4% of renal injuries were caused by a penetrating mechanism in a study of 6231 renal injuries, representing the injury experience of 62% of the USA population [1].…”

Section: Epidemiologymentioning

confidence: 99%

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Evaluation and management of renal injuries: consensus statement of the renal trauma subcommittee

et al. 2004

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Section: Epidemiologymentioning

confidence: 99%

“…Civilian violence is decreasing in the USA [1]; the rate of penetrating injury was significantly higher in the 1960s to early 1990s than at present [27,28]. Wartime renal injuries to USA soldiers also appear to be decreasing.…”

Section: Epidemiologymentioning

confidence: 99%

Evaluation and management of renal injuries: consensus statement of the renal trauma subcommittee

et al. 2004

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“…10 Pre-existing renal pathology is reputed to result in increased renal injury from blunt trauma due to gross pyelographic distortion. 8 A literature review revealed one case of bilateral rupture of polycystic kidneys that required bilateral nephrectomy by Leslie et al 7 A more recent case report by Reay et al in 2008 described a haemodynamically unstable patient with PCKD and a grade IV renal injury on CT scan who subsequently underwent selective arterial catheterization and coil embolization of a left renal artery branch pseudoaneurysm with frank extravasation. 12 The patient was treated successfully and recovered without loss of renal function.…”

Section: Discussionmentioning

confidence: 99%

Bilateral nephrectomies following rupture of polycystic kidneys in blunt renal trauma

et al. 2010

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Renal trauma accounts for approximately three percent of all trauma admissions. Most cases are self-limiting and minor but blunt renal trauma results in a spectrum of injuries ranging from simple contusions to renal pedicle avulsion. 2,3 Patients with known renal abnormalities are at increased risk of injury from blunt abdominal trauma. Here we present a patient with polycystic kidney disease (PCKD) who suffered blunt abdominal trauma resulting in multicystic heamorrhage. The subsequent management of this patient was dictated in part by her transfusion requirements and preexisting renal function. Consideration of the above factors is important given the high incidence of eventual renal transplantation requirements in these difficult patients.

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“…Indications for operative intervention were exsanguinating haemorrhage, intermittent or continuous haematuria of moderate severity, a flank mass increasing in size or evidence of a falling haematocrit, despite adequate blood replacement. Urinary extravasation per se is not associated with serious sequelae (Chavnick and Newman, 1960;Nation and Massey, 1968), and in the absence of suspected infective complications was not considered as an indication for exploration. In 13 of the 14 patients the initial management of the renal injury was conservative.…”

Section: Managementmentioning

confidence: 99%

Segmental dearterialization in penetrating renal trauma

Angorn

1977

British Journal of Surgery

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Refractory renal haemorrhage following low velocity penetrating trauma has conventionally been treated by nephrectomy or partial nephrectomy. Anatomical studies have demonstrated that the renal artery branches are end-arteries, each branch supplying a renal segment, with no collateral artery supply between segments. Life-threatening haemorrhage is arterial, and usually issues from a single segmental artery easily demonstrable by renal angiography. Fourteen patients had various segmental arteries ligated to control haemorrhage. Associated visceral injuries were present in 4 patients. Preoperative selective renal arteriography was possible in 13 patients and demonstrated the bleeding site in all cases. Segmental dearterialization produced haemostasis in 12 of the 14 patients. One patient required nephrectomy and one patient ligation of a second segmental artery to control bleeding. All the patients survived the operative procedure. Supine renin levels were normal on the fourteenth postoperative day and no patient developed hypertension during the follow-up period of 9-24 months. Segmental renal dearterialization by open operation is a simple and effective technique of controlling refractory renal haemorrhage with maximum preservation of renal parenchyma.

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Renal Trauma: Experience with 258 Cases

Cited by 54 publications

References 4 publications

Evaluation and management of renal injuries: consensus statement of the renal trauma subcommittee

Evaluation and management of renal injuries: consensus statement of the renal trauma subcommittee

Bilateral nephrectomies following rupture of polycystic kidneys in blunt renal trauma

Segmental dearterialization in penetrating renal trauma

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