Renal artery embolisation immediately prior to emergency trauma nephrectomy

Abstract

The aim of emergency nephrectomy in cases of blunt renal trauma is to control bleeding and so should not be delayed. We present a case of grade V blunt renal trauma where renal artery emoblisation (RAE) was used in the operating theatre immediately prior to trauma nephrectomy in order to control arterial haemorrhage. In this case, prior utilisation of RAE allowed the urologist to perform a standard approach to the renal pedicle by opening the retroperitoneal space. This is more routinely practiced and carries less risk of vascular mesenteric injury compared with the standard approach in trauma. Intra-operatively, there was minimal bleeding and the intra-vascular coils were easily ligated. Post operatively the patient avoids the sequelae of an ischaemic kidney associated with delayed interval nephrectomy.