Objective:
We aimed to evaluate our clinical approach in patients with renal ›njury.
Material and Methods:
Eighteen patients who had attended to our clinic with renal trauma between 2002 and 2006 were included in this study.
Results:
Mean age of the patients was 25.6±8.4 years and female/male ratio was 1/17. When etiologic causes were evaluated, 10 patient had penetrating trauma (8 stab wounds and 2 gunshot wounds) and 8 patients had blunt trauma (4 pedestrian accidents, 2 falls from height, 1 motor-vehicle accident and 1 fall from bicycle). Abdominal computerized tomography with i.v. contrast was obtained for all patients prior to hospitalization. According to American Association of Trauma Surgery Organ Injury Scale, 2, 3, 4, 7 and 2 of the patients had grades 1, 2, 3, 4 and 5 injuries, respectively. All patients with grades 1-3 injuries and 6 patients with grade 4 injury were managed conservatively. Partial nephrectomy was performed in one patient with grade 4 renal injury and nephrectomy was performed in 2 patients with grade 5 renal injury. It was observed that renal functions of a patient with grade 4 renal injury, who was managed conservatively, were progressively decreased.
Conclusion:
Patients with grades 1-3, even grade 4 renal injury can recover after conservative management. Conservative management should be thought at the first hand in hemodynamically stable patients.
Keywords: Renal trauma, conservative management, nephrectomy