Penetrating renal injuries

A retrospective analysis of 81 penetrating renal injuries revealed a need for surgical exploration in only 39 per cent, and the following conclusions are made: (1) Criteria for classifying a traumatic renal injury as major and therefore requiring further evaluation (arteriography) or appropriate urgent surgery, include urographic nonfunction or extravasation, persistent or severe hematuria or retroperitoneal hemorrhage, and deteriorating clinical status. (2) Preoperative urologic assessment is mandatory to avoid needless renal exploration; 58 per cent of patients with minor injuries were in this series operated on. (3) It is doubtful that late sequelae of penetrating renal injury occur so frequently that immediate surgery to prevent them is advisable.