Revista do Colégio Brasileiro de Cirurgiões
Print version ISSN 0100-6991
PEREIRA JUNIOR, Gerson Alves et al. Renal trauma. Rev. Col. Bras. Cir. [online]. 1999, vol.26, n.1, pp. 57-66. ISSN 0100-6991. http://dx.doi.org/10.1590/S0100-69911999000100012.
We present a revision of the renal trauma with emphasis in the radiographic evaluation, particularly CT scan that it has largely replaced the excretory urogram and arteriogram in the diagnostic worh-up and management of the patient with renal trauma. The successful management of renal injuries depends upon the accurate assessment of their extent in agreement with Organ Injury Scaling classification. The conservative therapy managed by careful continuous observation, bed rest, appropriate fluid ressuscitation and prophylactic antibiotic coverage after radiographic staging for severely injured kidneys can yield favorable results and save patients from unnecessary exploration and possible renal loss. The indications for immediate exploratory laparotomy were acute abdomen, rapidly dropping hematocrit or associated injuries as determinated from radiologic evaluation. When indicated, renal exploration after trauma is safe and in a high percentage of cases reconstruction will be successful. Isolation of the renal vasculature before exploration of the renal trauma is believed to reduce blood loss, allow for more careful and confident renal inspection and reconstruction, and reduce the probability of nephrectomy.
Keywords : Renal trauma; Kidney; Trauma; Wounds and injuries; Tomograph.