Traumatic veno-caliceal fistula in a solitary kidney

We present herein what we believe to be the first reported case of a traumatic veno-caliceal fistula and describe our technique for surgical repair. We use a transabdominal approach for renal trauma and advocate occlusion of the renal artery alone during intrarenal surgery. We believe that conservative management of renal injuries, even with a solitary kidney, yields the highest salvage rate. Initial arteriography best delineates most renal injuries and is a safe technique for following progressive changes that may require an operation. When injury occurs in a solitary kidney medical renal consultation and facilities for interim dialysis must be readily available.