Penetrating renovascular trauma

A 10-year experience with 39 patients having 40 renovascular injuries is presented. The overall mortality rate was 30%, predominantly from extensive associated trauma. Nephrectomy was performed in 20 patients (51%). Only 50% of the patients had attempted repair or ligation of the renal vessels. Renal salvage was possible in 23% of the total group and included 33% of these for isolated renal artery injuries and 43.6% for renal vein injuries. Our experience and a review of the literature suggest that nephrectomy still is the most expeditious method of management of renal vascular injuries. The extent of the associated trauma determines the fate of the involved kidney after renovascular trauma. Renal artery repair rarely is possible and seldom is successful. Renal vein injuries carry a better prognosis.