Grade IV renal trauma in a patient with a solitary kidney

A 60-year-old woman with a grade IV trauma to a solitary kidney was referred to our hospital. After primary conservative management, a continuous decline of the renal function required surgical exploration with decompression and renal reconstruction on the 4th day after the trauma. Postsurgical anuria prompted insertion of a ureteral stent; thereafter the renal function recovered quickly. A urinoma caused by a urinary fistula emerged 6 months after the trauma and was treated by percutaneous drainage, ureteral stenting, and percutaneous occlusion with fibrin sealant. Twelve months after the trauma, the patient is symptom free with a normal renal function.