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Focused Assessment with Sonography for Trauma FAST Exam: Image Acquisition
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Renal trauma: the current best practice.

Tomer Erlich1, Noam D Kitrey2

  • 1Department of Urology, The Chaim Sheba Medical Center, Tel Hashomer, Israel.

Therapeutic Advances in Urology
|September 7, 2018
PubMed
Summary
This summary is machine-generated.

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.

Keywords:
hematuriakidney injurymultiple traumarenal injury

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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.