Related Experiment Video
Updated: Feb 5, 2026
Focused Assessment with Sonography for Trauma FAST Exam: Image Acquisition
Published on: September 22, 2023
Renal trauma: the current best practice
1Department of Urology, The Chaim Sheba Medical Center, Tel Hashomer, Israel.
Abstract:
The kidneys are the most vulnerable genitourinary organ in trauma, as they are involved in up to 3.25% of trauma patients. The most common mechanism for renal injury is blunt trauma (predominantly by motor vehicle accidents and falls), while penetrating trauma (mainly caused by firearms and stab wound) comprise the rest. High-velocity weapons impose specifically problematic damage because of the high energy and collateral effect. The mainstay of renal trauma diagnosis is based on contrast-enhanced computed tomography (CT), which is indicated in all stable patients with gross hematuria and in patients presenting with microscopic hematuria and hypotension. Additionally, CT should be performed when the mechanism of injury or physical examination findings are suggestive of renal injury (e.g. rapid deceleration, rib fractures, flank ecchymosis, and every penetrating injury of the abdomen, flank or lower chest). Renal trauma management has evolved during the last decades, with a distinct evolution toward a nonoperative approach. The lion's share of renal trauma patients are managed nonoperatively with careful monitoring, reimaging when there is any deterioration, and the use of minimally invasive procedures. These procedures include angioembolization in cases of active bleeding and endourological stenting in cases of urine extravasation.
Insights
Renal trauma is common in genitourinary injuries, often caused by blunt force. Modern management favors nonoperative approaches with minimally invasive procedures for active bleeding or urine leaks.
Area of Science:
- Urology
- Trauma Surgery
- Radiology
Background:
- Kidneys are highly vulnerable genitourinary organs in trauma.
- Renal injuries occur in up to 3.25% of trauma patients.
- Blunt trauma (MVA, falls) is the most common cause, followed by penetrating trauma (firearms, stab wounds).
Purpose of the Study:
- To review the diagnosis and management of renal trauma.
- To highlight the evolution towards nonoperative management strategies.
Main Methods:
- Contrast-enhanced computed tomography (CT) is the primary diagnostic tool.
- CT is indicated for stable patients with gross hematuria, microscopic hematuria with hypotension, and suggestive injury mechanisms or physical findings.
- Management strategies include nonoperative approaches with monitoring and minimally invasive interventions.
Main Results:
- Nonoperative management is the mainstay for most renal trauma patients.
- Minimally invasive procedures like angioembolization and endourological stenting are crucial for specific complications.
- Angioembolization addresses active bleeding; stenting manages urine extravasation.
Conclusions:
- Renal trauma diagnosis relies heavily on CT scans.
- The trend in renal trauma management is increasingly nonoperative.
- Minimally invasive techniques are vital adjuncts to nonoperative care for specific renal injuries.
Related Concept Videos
01:17Factors Affecting Renal Clearance: Renal Impairment
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:10Electrical Current
01:20Renal Corpuscle
Glomerulus: Structure and Function
The glomerulus is a tiny, intricate network of capillaries located at the beginning of the nephron. It's enveloped by the Bowman's capsule and receives its blood supply from an afferent arteriole, which divides into numerous...
01:23Renal Clearance
Renal clearance refers to the volume of plasma cleared of a specific substance, such as creatinine, per unit of time. To measure clearance, urine samples are collected over a 24-hour period during each bladder voiding, followed by a single blood sample at the...
01:16Characteristics of Practical Op Amps
The ratio of differential gain to the common-mode gain is defined as the common-mode rejection ratio (CMRR). This ratio quantifies the ability of operational amplifiers (op-amps) to reject common-mode...
01:30Theoretical Foundations of Nursing Practice
Theories provide a perspective to assess patients' conditions and organize data and methods. They also assist in analyzing and interpreting information. They represent a...