Conservative Salvage of a Penetrating Grade IV Renal Injury with Extravasation

Abstract

Penetrating abdominal injuries have traditionally been managed with surgical exploration. The recent trend in renal trauma is selective nonoperative management, even if laparotomy is performed for associated injuries. This case describes the salvage of a grade IV kidney injury secondary to gunshot wound. A large perinephric hematoma and associated hollow viscus injury were discovered on CT scan. The patient underwent laparotomy for colonic repair. The perinephric hematoma appeared non-pulsatile, nonexpanding, and not actively bleeding, and thus was not explored. The injured kidney healed and the patient did not require nephrectomy