Selective Management of Isolated and Nonisolated Grade IV Renal Injuries

Buckley, Jill C.; McAninch, Jack W.

doi:10.1016/j.juro.2006.07.141

Cited by 89 publications

(65 citation statements)

References 14 publications

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“…Whereas only 8 of the 10 children (80%) with a grade IV BRI were successfully managed nonoperatively, all 10 children with a grade V BRI required an IO, and only 3 (30%) achieved long-term preservation of renal function. In our study, of the 52 patients who received an IO, 18 (34.6%) underwent a renal-salvage procedure (defined as a functioning renal unit of 50% or more 25 An age of older than 55 years and a road traffic crash as the mechanism of injury were the 2 independent predictors in our study, and they both increased the odds of f-NOM by nearly 6-fold. Although an older age does not come as a surprise, the specific mechanism of injury requires further exploration.…”

Section: Discussionmentioning

confidence: 62%

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Successful Nonoperative Management of the Most Severe Blunt Renal Injuries

et al. 2013

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Section: Discussionmentioning

confidence: 62%

“…Morbidity and mortality were higher among IO patients than NOM patients, and ICU and hospital stays were longer for IO patients than NOM patients. There were 4 independent predictors of IO: ISS greater than 25 …”

Section: Nom Vs Iomentioning

confidence: 99%

Successful Nonoperative Management of the Most Severe Blunt Renal Injuries

et al. 2013

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“…1). Improvements in resuscitation management of trauma patients changed the concept of NOM in high-grade renal injury and highly-selective embolization skills shifted the treatment strategy toward NOM in severe blunt renal trauma patients [10][11][12]. Angioembolization was performed in cases of extravasation on abdominal/pelvic CT or of sus- In both the operative and NOM groups, no mortality was related to renal injury.…”

Section: Discussionmentioning

confidence: 99%

Management of High-grade Blunt Renal Trauma

Lee

Jang

Lee

2017

Journal of Trauma and Injury

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Purpose: Blunt injury accounts for 80-95% of renal injury trauma in the United States. The majority of blunt renal injuries are low grade and 80-85% of these injuries can be managed conservatively. However, there is a debate on the management of patients with high-grade renal injury. We reviewed our experience of renal trauma at our trauma center to assess management strategy for high-grade blunt renal injury. Methods: We reviewed blunt renal injury cases admitted at a single trauma center between August 2007 and December 2015. Computed tomography (CT) scan was used to diagnose renal injuries and high-grade (according to the American Association for the Surgery of Trauma [AAST] organ injury scale III-V) renal injury patients were included in the analysis. Results: During the eight-year study period, there were 62 AAST grade III-V patients. 5 cases underwent nephrectomy and 57 underwent non-operative management (NOM). There was no difference in outcome between the operative group and the NOM group. In the NOM group, 24 cases underwent angioembolization with a 91% success rate. The Incidence of urological complications correlated with increasing grade. Conclusions: Conservative management of high-grade blunt renal injury was considered preferable to operative management, with an increased renal salvage rate. However, high-grade injuries have higher complication rates, and therefore, close observation is recommended after conservative management.

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“…Persistan kanama eksplorasyon ve rekonstrüksiyon için ana indikatördür (30) . Ateşli silah yaralanmaları ancak renal hilumu içerdiğinde veya kendini sınırlamayan kanama bulguları olduğunda, üreteral yaralanmalarda ya da renal pelvis laserasyonlarında eksplore edilmelidir.…”

Section: Tedaviunclassified

Current Approachs to Urogenital System Injuries in High Energy Trauma Exposed

Değirmentepe¹,

Polat²,

Ötünçtemur³

2017

Okmeydani Medical Journal

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ÖZ GİRİŞÜriner sistemin organları, idrar oluşturma (böbrek), idrar iletme (üreterler ve üretra) veya idrar depolamaya (mesane) dayalı olarak vücudun diğer katı ve içi boş organlarından farklıdır (1) . Genitoüriner sistem travmaları tüm travma olgularının %10'unu oluştur-masına rağmen, önemli bir konudur (2) . Künt karın yaralanması denildiğinde ne tür nesne ile oluşursa oluşsun karın duvarı bütünlüğü bozulmaksızın karın içi organlarda yaralanma oluşturan travma anlaşılır. Künt yaralanmalar genellikle motorlu araç kazaları, yüksekten düşme ve şiddet içeren saldırılar sonucu meydana gelir. Künt travmaların en sık nedeni trafik kazalarıdır. Hareket halinde ani yavaşlamalar veya alınan darbeye bağlı ezilmeler organlarda yırtılma veya kontüzyon ile sonuçlanabilir (2) . Penetran travmada karın duvar bütünlüğü bozulmuştur. Penetran (delici-kesici) yaralanmaların en sık nedeni ateşli silahlarla veya bıçaklı saldırılara bağlı delici kesici alet yaralanmalarıdır. Penetran yaralanmalar künt yaralanmalara göre daha ciddi seyreder. Kentsel bölgelerde penetran travma görülme yüzdesi artar (3) . Ateşli silah kullanımına bağlı oluşan yaralanmalarda organlarda büyük parankimal hasarlar gözlemlenir ve genellikle çoklu organ yaralanması eşlik etmektedir. Ateşli silah yaralanmasının ilk değerlendirilmesinde, neden olan silahın özellikleri ve mermi balistiği önemli faktör-lerdendir. Yumuşak doku hasarında en önemli faktör merminin hızı ve boyutudur (4,5) . BalistikMerminin doku ve organlar üzerindeki etkileri, diğer yaralanmalardan farklıdır. Önceleri kurşun yarasının şiddetinin silahla üretilen enerjiye bağlı olduğuna inanılıyordu (E=1/2 MV2). Bu teoriye göre, merminin büyüklüğü ve hızı enerji üretiminde önemlidir. Sonradan, bu teorinin doğru olmadığı belirlendi, çün-kü dokuya aktarılan enerji doku hasarında kritik bir

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Selective Management of Isolated and Nonisolated Grade IV Renal Injuries

Cited by 89 publications

References 14 publications

Successful Nonoperative Management of the Most Severe Blunt Renal Injuries

Successful Nonoperative Management of the Most Severe Blunt Renal Injuries

Management of High-grade Blunt Renal Trauma

Current Approachs to Urogenital System Injuries in High Energy Trauma Exposed

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