Renal trauma found during laparotomy for intra-abdominal injury

A. S. Cass, M. Bubrick, M. Luxenberg, P. Gleich, C. Smith

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Whether renal injury found during a laparotomy for intra-abdominal injury should have surgical or nonsurgical management is controversial. Five hundred twenty-one renal injuries were found during laparotomy for such injury in 513 patients. Blunt external trauma was the cause in 88%. A modified operating room table enabled performance of immediate intravenous pyelogram during the laparotomy. More severe degrees of renal injury (laceration, rupture, pedicle injury) were present in 135 (26%) of the renal injuries. Immediate surgical management of 102 more severe renal injuries resulted in nephrectomies in 37 (36%), delayed renal surgery in one (0.9%), and renal salvage in five of 18 (27%) main renal artery and/or vein injuries. Nonsurgical management of the remaining 23 resulted in nephrectomies in three (13%), delayed renal surgery in six (26%), total renal loss in seven of seven (100%) main renal artery injuries and an overall nephrectomy/total renal loss rate of 39%. With immediate surgical management of the more severe degrees of renal injury there was a slight increase in the salvage of kidneys and a marked decrease in delayed renal surgery and morbidity.

Original languageEnglish (US)
Pages (from-to)997-1000
Number of pages4
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume25
Issue number10
DOIs
StatePublished - Oct 1985

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