Management Of Blunt Renal Trauma Research Articles

Management of blunt renal trauma on pre-existing diseased kidneys: a cross-sectional study.

Our objective was to determine the clinical, radiological, and therapeutic features of this entity. The medical records of 37 observations were retrospectively collected from January 1992 to February 2022. All cases were explored by a kidney ultrasound and/or a computed tomography scan, and classified according to the American Association of Surgery of Trauma. Pre-existing renal abnormalities were found in 37 patients among 203 (18.2%). The most common underlying lesion were urolithiasis (37.8%) followed by pyelo-ureteral junction syndrome (32.4%). Surgical abstention was decided in 11 cases, four nephrectomies were performed as a matter of urgency, and seven nephrectomies were performed remotely. The cure of uropathy was performed after an average delay of 3 months. Kidneys with underlying pathology are habitually more susceptible to trauma. Contusions are often benign contrasting with a high nephrectomy rate.

Outcome of angioembolization for blunt renal trauma in haemodynamically unstable patients: 10-year analysis of Queensland public hospitals.

The aim of the study was to evaluate whether angioembolization is an appropriate alternative method for the management of blunt renal trauma in haemodynamically unstable patients. A retrospective analysis was conducted from 2002 to 2012 at three tertiary trauma hospitals in the state of Queensland. Patients who had blunt renal trauma and underwent renal angioembolization or had a trauma nephrectomy were identified using patient records and operating theatre and interventional radiology databases. The inclusion criteria were - haemodynamically unstable patients with blunt renal trauma treated with angioembolization, above the age of 16 years. Patients who underwent angioembolization for other causes such as: penetrating renal trauma, post-procedure, renal tumours, renal angiomyolipomas or arteriovenous malformations were excluded. Patients below the age of 16 were also excluded. Post-embolization renal function, blood pressure, morbidity and mortality were analysed using the paired t2 test. A total of 668 renal trauma patients were identified during this period. Sixteen patients underwent angioembolization for blunt renal trauma. Post-procedure renal function normalized without any hypertension with the median follow up being 4 months. Four patients had post-embolization complications including a urinoma, two devascularized kidneys and one ureteric stricture requiring nephrectomy. There was no mortality. Selective angioembolization, where feasible, is an alternative method in the management of haemodynamically stable patients with blunt renal trauma maximizing nephron sparing and producing acceptable long-term outcomes with avoidance of the morbidity of trauma nephrectomy. This is the first study that we know of in Australia analysing the outcome of angioembolization for blunt renal trauma.

Pediatric Blunt Renal Trauma. A Single Institution’s 20 Years Experience with Surgically Treated Patients.

Background: Kidney is the most common site of genitourinary trauma. 50% of all urinary injuries is kidney.Kidney is also affected in 8-12% of all blunt and penetrating trauma to abdomen. 80-90% of renal injury is caused by blunt injury GY. Children, compared to adults, have at a higher risk of renal injury from blunt trauma due to a variety of anatomic factors including decreased perirenal fat, weaker abdominal muscles, and a less ossified thoracic cage. While there are strong trends toward non-operative management of blunt renal trauma, there are no explicit guidelines for high grade injuries. Organ preservation in children is always a primary goal with solid organ injury.
 Aim of the work: The aim of the retrospective study is to show the specificity of kidney injury in children as well as the specificity of surgical treatment.
 Material and Methods: All 19 patients under the age of 18 who were admitted to Clinic for Pediatic surgery in Sarajevo with a diagnosis of renal trauma were retrospectively reviewed .The Echo an CT were used to identify patients with a renal injury. The time period examined was between January 1, 1999- 2019. Inclusion criteria were either a diagnosis of renal trauma or a diagnosis of blunt abdominal trauma and hematuria. Exclusion criterion was death due to an additional traumatic injury. The mechanism of injury (fall, car accident , assault) injury grade (I-V), the presence of hematuria, and demographic data to include age, weight, and sex, were recorded and reviewed. In addition, amount of blood product required, hematocrit nadir prior to transfusion to assist in ascertaining whether transfusion was necessary, surgical interventions performed, and hospital length of stay were also retrospectively analyzed. Due to the low sample size we used descriptive as opposed to inferential statistics in our analysis.
 Result: Demographics include male to female ratio of 13:6 and the average age of patients was 11.9 + 4.6 years. Of the nineteen patients who underwent review, eleven (57,89%) children presented with a grade III renal injury, five with a grade IV injury and three with grade V injury. Six patients presented with gross hematuria and 3 with microscopic hematuria. Only four patients (22%) required blood transfusions, with the average hematocrit nadir being 31 + 5.3% (24.8-37.8). One of the two patients transfused had a concomitant grade IV splenic laceration with a hematocrit nadir of 24.8% and clinical symptoms consistent with shock.
 Conclusions:The specificity of the child's anatomy is an aggravating prognostic factor (the kidney is larger in relation to the body cavity than in adults, less protected against the ribs, the muscles of the body and the lower abdomen, the less developed peritoneal and retroperitoneal fatty tissue).It is recommended to initiate conservative treatment (leaching, infusion solution, monitoring) and possibly delayed surgical treatment.Indications for early surgicaly treatment are reserved only for patients with bleeding (absolute) and extravasation (relative).If it is necessary surgical treatment sould be maximally preserve kidney tissue.

Management of blunt renal trauma in a tertiary hospital of south India: a retrospective single centre study

Management of blunt renal trauma in a tertiary hospital of south India: a retrospective single centre study

A tertiary care experience of conservative management of blunt renal trauma in northern India: A prospective study

A tertiary care experience of conservative management of blunt renal trauma in northern India: A prospective study

Management of Blunt Renal Trauma: An Experience from Tertiary Hospital

Management of Blunt Renal Trauma: An Experience from Tertiary Hospital

PD63-06 NONOPERATIVE MANAGEMENT HAS SIGNIFICANTLY INCREASED FOR BOTH BLUNT AND PENETRATING RENAL TRAUMA: DATA FROM THE NATIONAL TRAUMA DATA BANK

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: External Genitalia Reconstruction and Urotrauma (including transgender surgery) II1 Apr 2017PD63-06 NONOPERATIVE MANAGEMENT HAS SIGNIFICANTLY INCREASED FOR BOTH BLUNT AND PENETRATING RENAL TRAUMA: DATA FROM THE NATIONAL TRAUMA DATA BANK Marc Colaco, Susan MacDonald, and Ryan Terlecki Marc ColacoMarc Colaco More articles by this author , Susan MacDonaldSusan MacDonald More articles by this author , and Ryan TerleckiRyan Terlecki More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2930AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Management of blunt renal trauma has evolved to favor a conservative approach. Penetrating trauma, however, has traditionally involved surgical intervention. The purpose of this study is to compare the trends in operative and nonoperative management following blunt and penetrating renal trauma. METHODS A retrospective cross sectional analysis was performed using data from 2002-2012 within the National Trauma Data Bank (NTDB). Cases were identified by ICD-9 diagnosis codes. Codes 866.00 through 866.03 and 866.10 through 866.13 were queried for blunt and penetrating renal trauma, respectively. Only cases requiring interventions were included. Treatments were identified using ICD-9 procedure codes for nephrectomy (55.5x), renal laceration repair (55.81), arteriography (88.45) or endovascular repair (39.79). RESULTS 4296 cases were reported during the study period. Of these, 2635 involved blunt trauma and 1661 involved penetrating injury. Following blunt trauma, there was a significant increase in the percentage of cases managed by endovascular means (R2=0.92, p<0.01) with a corresponding decrease in the amount of patients undergoing both nephrectomy (R2=0.32, p=0.068) and laceration repair (R2=0.54, p<0.01) [Figure 1a]. Following penetrating trauma, there was also a significant decrease in nonoperative management (R2=0.69, p<0.01) largely explained by a decline in nephrectomy (###). Endovascular interventions significantly increased (R2=0.87, p<0.01) [Figure 1b]. These cases, however, were predominantly managed with laceration repair with no significant change over the study period. CONCLUSIONS Surgical intervention for blunt and penetrating trauma continues to decrease. Procedural intervention for blunt renal trauma largely consists of endovascular management. Although most interventions for penetrating trauma involve repair, nephrectomy has significantly decreased while endovascular management has increased. Future efforts should aim to characterize whether the current trends in surgical intervention following penetrating renal injuries is appropriate and if outcomes data warrants a change in guidelines that may allow for quality improvement and decreased morbidity. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1256 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Marc Colaco More articles by this author Susan MacDonald More articles by this author Ryan Terlecki More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Renal Trauma: When to Embolize?

Purpose of Review The management of solid organ injury continues to evolve from operative therapy to non-operative therapy with the highest success rates seen in the management of blunt renal trauma. Angio-embolization has emerged as an important modality to increase the success rate of non-operative management of kidney injuries.

FRII-02 THE MANAGEMENT OF GENITOURINARY TRAUMA IN WORLD WAR II

You have accessJournal of UrologyHistory of Urology: History Forum II1 Apr 2016FRII-02 THE MANAGEMENT OF GENITOURINARY TRAUMA IN WORLD WAR II Joseph Sterbis, Ronald Caras, John Musser, and Ryan Speir Joseph SterbisJoseph Sterbis More articles by this author , Ronald CarasRonald Caras More articles by this author , John MusserJohn Musser More articles by this author , and Ryan SpeirRyan Speir More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2923AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES During the course of World War II, the United States lost over 400,000 service members, with more than 600,000 wounded. Genitourinary injury accounted for approximately 0.5% of those wounded. Our intent is to review the injuries and treatment modalities from that time, allowing for contemporary comparison. METHODS Primary and secondary literature sources were reviewed from World War II and the post-war era. These sources were surveyed to determine the organ-specific incidences of injury, the nature of combat-related genitourinary trauma, and the surgical and medical therapies utilized in both forward and rear echelons. RESULTS Reports of organ-specific injury rates demonstrate varied incidences: Kidney: 25-40%, External Genitalia: 30-56%, Bladder: 12-15%, Ureter: 1-3%. Reports following the war that discuss treatment modalities focus on immediate control of hemorrhage, urinary drainage, and infection control. Preoperative imaging of the kidney was considered of great importance when feasible, with authors recommending a one-shot intravenous pyelogram as a minimum. Conservative management of blunt renal trauma was advocated. Renorraphy was performed when feasible in penetrating trauma. Vascular repair was also considered, though no reported cases were identified. Upper ureteral injuries were managed with early repair over a catheter, while lower injuries were reimplanted. The Davis intubated ureterotomy, first reported in 1946, was advocated as a means for management of post-traumatic stricture. Extraperitoneal bladder injuries were managed conservatively or with repair if surgery for other injuries was planned. Intraperitoneal bladder injuries were managed with repair and suprapubic cystostomy. Posterior urethral injuries were managed via suprapubic diversion and early surgical approximation, the nature of which was ill-defined. Neurogenic bladder from spinal cord injury was generally managed with suprapubic cystostomy, with authors very clear that such injuries were not to be managed with intermittent catheterization. CONCLUSIONS With this year marking the 71st anniversary of the conclusion of World War II, review of historic data provides perspective informing our contemporary combat trauma management. With the notable exception of neurogenic bladder, many management principles have been preserved over time. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e521 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Joseph Sterbis More articles by this author Ronald Caras More articles by this author John Musser More articles by this author Ryan Speir More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Management of blunt renal trauma

Non-operative management of renal injuries has gained acceptance in the past few decades. We report our experience of the management of blunt renal trauma at our hospital between January 2007 and July 2014. This study illustrates that non-operative treatment of major renal lacerations with or without urinary extravasation is safe and effective in haemodynamically stable patients. A significantly higher rate of double J stent insertions was deployed in this study for injuries with significant extravasation, which did not have any detrimental effect and an overall excellent outcome was observed.

Nonoperative Management of Blunt Renal Trauma

ABSTRACT Objective To analyze patients with blunt renal trauma who were managed conservatively, with emphasis on clinical presentation, grade of injury, complication and failure rates. Materials and methods A prospective observational study was conducted in Hospital João XXIII, between January and December 2013. Patients with blunt renal trauma and nonoperative management (NOM) were analyzed during this period. Data were collected in respect to: age, gender, mechanism of trauma, grade of injury, clinical presentation, revised trauma score (RTS), associated abdominal injuries, length of hospital stay and failure, complication and mortality rates. Results During this period, 27 patients with blunt renal trauma were suitable for nonoperative approach. The most common mechanisms of trauma were motor vehicle accidents (59.2%) and falls (22.2%) and the mean length of hospital stay was 10.5 days. The majority of the patients had grade II (48.1%) and III (29.6%) injuries, with mean RTS of 6.93. The complication rate was 3.7% and the mortality rate was 7.4%. All deaths were related to associated injuries. One patient with grade II injury required nephrectomy. This patient had concurrent injuries. Conclusion Blunt renal trauma can be successfully managed conservatively, with low complication rates. Nonoperative management is safe in stable patients and in environments with appropriated protocol for this approach. How to cite this article Franciscani AAR, Azevedo CI, Souza AB, Costa MHA, Starling SV, Drumond DAF. Nonoperative Management of Blunt Renal Trauma. Panam J Trauma Crit Care Emerg Surg 2015;4(1):6-10.

Renal Trauma after Blunt Abdominal Injury

BackgroundThe kidney is the third most common solid organ injury in blunt abdominal trauma. The preferred treatment of blunt kidney injury varies according to grade of severity, with a preference for non-operative management in most instances. DiscussionWe examine an unusual case of blunt renal trauma. In this case, our patient presented with severe flank pain and hematuria after a game of softball. Our focused abdominal sonography for trauma revealed fluid in the splenorenal recess concerning for intra-abdominal injury, and subsequent abdominal computed tomography confirmed a grade IV kidney laceration. ConclusionOur patient was managed medically despite his high grade of injury. This article reviews the diagnosis and management of blunt renal trauma and highlights the fact that despite significant injury, a patient can go on to do well with conservative management alone.

Management of blunt renal trauma: an experience in 84 children

The study aimed to investigate the method of management and diagnosis of pediatric blunt renal trauma, and determine whether all grades of hemodynamically stable injuries can be managed conservatively. Eighty-four children, presented with blunt renal trauma and treated in the urinary surgery department of Children's Hospital of Chongqing Medical University, were reviewed. Data collected from the medical records of the identified patients included: (1) demographics, (2) management, (3) severity of hematuria, (4) findings on computed tomography, (5) associated injuries, (6) duration of hospital stay, and (7) follow-up complications. Of the 84 patients, only 11 (13%) required operations. Five (6%) patients were immediately operated for vascular instability; one (1.2%) patient had delayed operation for missed Ureteropelvic Junction (UPJ) disruption, one (1.2%) patient for abscess, and four (4.7%) patients for persistent bleeding. All the children with low-grade injuries and part of them with high-grade injuries were selected for nonoperative management of real injuries. The diagnosis rate of blunt renal trauma using Ultrasonography (US) was 91%. The rate of diagnosis by intravenous pyelography (IVP) was 82% and that by computed tomographic (CT) was 100%. However, Ultrasonography could not diagnose all patients with grade I injuries. Only 3 (8%) of 36 children had hypertension managed conservative by followed-up for 4months. The goals of treatment of blunt renal injuries include minimizing accrued staging and complications. Our study supported that conservative management is the first choice for all grades of hemodynamically stable children with blunt renal trauma. Abdominal CT scanning is the most accurate screening test for high-grade injuries and older children.

Grade 4 renal injury: current trend of management and future directions

The management of blunt renal trauma has been evolving. The past management largely based on American Association for Surgery of Trauma (AAST) grading system, i.e. necessitated a computed tomography (CT) scan. Although the CT scan use is increasing and becomes the standardized mode of investigation, AAST grading no longer plays the sole role in the decision of surgical interventions. Two case reports of blunt renal trauma managed successfully by conservative methods are presented. Case one was an 18 year-old boy who had a fall when riding a motorbike at 20 km/h with a helmet and full protective equipments. He was landed by his left flank onto a rock. Contrast abdominal CT revealed a 4 cm, grade III splenic tear and a grade IV left kidney injury with large perirenal haematoma. His international severity score (ISS) was 34. He was managed conservatively with bed rest and frequent serum haemoglobin monitoring. Subsequent CT with delayed contrast revealed stable perirenal haematoma with urine extravasation which was consistent with a grade IV renal injury. Case two was a 40 year-old male who had a motor bike accident on a racetrack when he was driving at 80 to 100 km/h, wearing a helmet. He lost control and hit onto the sidewall of the racetrack. Contrast abdominal CT revealed a grade IV left renal injury with a large urine extravasation. His renal injury was managed conservatively with interval delayed phase CT of the abdomen. A repeat CT on abdomen was performed five months after the initial injury which revealed no residual urinoma. In this study, moreover, a review of the literature to the management of blunt renal trauma was conducted to demonstrate the trend of increasing conservative management of such traumas. Extra radiological parameters may guide future decision making. However, the applicability of data may be limited until randomized trials are available.

43 A SUCCESSFUL PROSPECTIVE TRAIL OF CONSERVATIVE MANAGEMENT FOR PEDIATRIC BLUNT RENAL TRAUMA

You have accessJournal of UrologyTrauma/Reconstruction: Trauma & Reconstructive Surgery I1 Apr 201043 A SUCCESSFUL PROSPECTIVE TRAIL OF CONSERVATIVE MANAGEMENT FOR PEDIATRIC BLUNT RENAL TRAUMA Carrie Fitzgerald, Peter Tran, Jeff Burnell, and Richard Santucci Carrie FitzgeraldCarrie Fitzgerald More articles by this author , Peter TranPeter Tran More articles by this author , Jeff BurnellJeff Burnell More articles by this author , and Richard SantucciRichard Santucci More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.088AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Expectant management of hemodynamically stable blunt renal trauma is standard of care in adults. Conservative management of blunt renal trauma is also safe in properly selected pediatric patients. This study prospectively evaluated the safety and efficacy of an ultra conservative blunt renal trauma protocol at a Level 1 pediatric trauma center. METHODS Thirty-nine pediatric patients with blunt renal trauma were identified from 2003 to 2008. An ultra conservative approach was implemented in these consecutively presenting patients. Applied standards were as follows; imaging reserved for patients with gross hematuria, microscopic hematuria with concomitant shock or significant deceleration injury. Non-operative management if hemodynamically stable, responds favorably to < 2 units blood transfusions and imaging doesn't show lesion requiring operating (ureteral injury, Grade V vascular injury). Exploratory laparotomy for non-renal causes did not necessarily warrant renal exploration. Outcomes evaluated were injury grade, hematuria, operative management, length of stay and associated injuries. Study design was based on a successful, published retrospective review of blunt renal management from 1990 to 2002, at the same institution. RESULTS The 39 confirmed cases were assigned American Association for the Surgery of Trauma (AAST) renal injury, grade I (N=13), grade II (N=8), grade III (N=11), grade IV (N=6), grade V (N=1). Ultra conservative management resulted in a 100% renal salvage rate, 38 of 39 (97%) managed non-operatively and 1 of 39 (3%) requiring a delayed renorrhaphy. Prospective findings were comparable to results in retrospective review from 1990-2002. Combining datasets, 1990-2008 (N=100), a 99% renal salvage rate was seen. Mean length of stay (LOS) did not correlate with injury grade. LOS >10 days (N=7, mean 20 days) correlated only with the degree of non-renal injuries (100%), ventilator dependent respiratory failure (57%) and/or non-renal surgical intervention (43%). Salvage rates may reflect limited number of grade 5 blunt renal trauma cases 2003-2008 (N=1), 1990-2002 (N=2). CONCLUSIONS This is the first prospective study of a non-operative protocol for management of blunt pediatric renal trauma, which had been previously seen to be safe in a retrospective study at this same institution. Expectant management of non-exsanguinating pediatric blunt renal trauma is safe and effective. Also, serious renal injuries were not missed by applying adult diagnostic imaging protocols to children. Detroit, MI© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e18 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Carrie Fitzgerald More articles by this author Peter Tran More articles by this author Jeff Burnell More articles by this author Richard Santucci More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Review of the evidence on the management of blunt renal trauma in pediatric patients

Due to the size and location within the pediatric patient, the kidneys are susceptible to injury from blunt trauma. While it is clear that the goal of management of blunt renal trauma in children is renal preservation, the methods of achieving this goal have not been well established in the current literature. Therefore, we have set out to summarize and clarify the current published information on the management strategies for blunt renal trauma in children. While there is extensive literature available, it consists mostly of retrospective series documenting widely varied management styles. The purpose of this review is to display the current information available and delineate the role for future studies that may allow us to develop consistent management strategies of pediatric patients, who have sustained blunt renal trauma, in a safe and cost-effective manner.

Treatment in Pediatric Renal Trauma: A Conservative Management Approach

Purpose: The management of pediatric trauma is substantially derived from the results of adult trauma patient. Despite the increasing of pediatric renal trauma, the management of them still remains controversial. The aim of this study is to evaluate our experience with the expectant conservative management of blunt trauma in children. Materials and Methods: We retrospectively studied 45 pediatric patients with renal trauma between 1995 and 2007. We reviewed medical records for clinical symptoms, mechanism of injury, assigned grade of renal injury, associated injuries, indication of surgery, and treatment outcomes. We graded renal injuries according to the American Association for the Surgery of Trauma Organ Injury Scale. Results: All patients of grade I, II, III, and IV were managed conservatively at beginning, if the hemodynamic state is stable. Among them, 2 patients of grade IV were done delayed operation. One patient underwent delayed renorrhaphy for persistent anemia and hypotension, and the other patient needed delayed nephrectomy because of persistent fever and worsening abdominal pain with significant urinary extravasation. All patients of grade V were undergone early nephrectomy. Conclusions: Except for persistent fever with significant extravasation and grade V injury, initial conservative management of blunt renal trauma in children is effective and recommendable at beginning, if the hemodynamic state is stable. Prospective larger randomized controlled trials will be needed. (Korean J Urol 2009;50:1125-1132) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

Nonoperative management of blunt renal trauma: Is routine early follow-up imaging necessary?

BackgroundThere is no consensus on the role of routine follow-up imaging during nonoperative management of blunt renal trauma. We reviewed our experience with nonoperative management of blunt renal injuries in order to evaluate the utility of routine early follow-up imaging.MethodsWe reviewed all cases of blunt renal injury admitted for nonoperative management at our institution between 1/2002 and 1/2006. Data were compiled from chart review, and clinical outcomes were correlated with CT imaging results.Results207 patients were identified (210 renal units). American Association for the Surgery of Trauma (AAST) grades I, II, III, IV, and V were assigned to 35 (16%), 66 (31%), 81 (39%), 26 (13%), and 2 (1%) renal units, respectively. 177 (84%) renal units underwent routine follow-up imaging 24–48 hours after admission. In three cases of grade IV renal injury, a ureteral stent was placed after serial imaging demonstrated persistent extravasation. In no other cases did follow-up imaging independently alter clinical management. There were no urologic complications among cases for which follow-up imaging was not obtained.ConclusionRoutine follow-up imaging is unnecessary for blunt renal injuries of grades I-III. Grade IV renovascular injuries can be followed clinically without routine early follow-up imaging, but urine extravasation necessitates serial imaging to guide management decisions. The volume of grade V renal injuries in this study is not sufficient to support or contest the need for routine follow-up imaging.

MP-22.02: Evaluation and management of blunt renal trauma in adults with solitary kidney or impaired renal function

MP-22.02: Evaluation and management of blunt renal trauma in adults with solitary kidney or impaired renal function

170: Nonoperative Management of Blunt Renal Trauma: Is Routine Follow-Up Imaging Necessary?

170: Nonoperative Management of Blunt Renal Trauma: Is Routine Follow-Up Imaging Necessary?