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Renal Trauma: Dr. Ravi Roshan Khadka
Renal Trauma: Dr. Ravi Roshan Khadka
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Mode of injury to kidney
Blunt renal injuries
Motor vehicle accidents (m0st common cause) , falls
from heights, and assaults contribute to the majority of blunt
renal trauma.
Sudden deceleration may result in injury to the renal hilum
(renal vessels).
Penetrating renal injuries
It most often come from gunshot and stab wounds .
Bullets have the potential for greater parenchymal
destruction and are most often associated with multiple-
organ injuries .
Penetrating injury produces direct tissue disruption of the
parenchyma, vascular pedicles, or collecting system.
Classification of renal injury
Classification of renal injury
Diagnosis
History + examinations +
Investigations
Symptoms
Patient should be managed ATLS protocol
(Primary survey by ABCDE ) and only go for detail
diagnosis and management.
1. History of trauma
Possible indicators of major injury include
a history of a rapid deceleration event (fall, high-
speed MVAs) or
a direct blow to the flank.
Options
Renal Injury
Renorrhaphy (Renal reconstruction)
Partial nephrectomy
Simple nephrectomy (grade 5 )
Vascular injury
Vascular embolization (segmental vessel; grade 3)
Vascular reconstruction
Indications of Nephrectomy
Hemodynamically unstable patient, with low
body temperature and poor coagulation, with a
normal contralateral kidney.