ABSTRACT

We aimed to evaluate our clinical approach in patients with renal ›njury.

Eighteen patients who had attended to our clinic with renal trauma between 2002 and 2006 were included in this study.

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.

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.