Traumatic thrombosis of a segmental branch of the renal artery

Traumatic thrombosis of a segmental renal artery branch is being diagnosed with increased frequency because of the more frequent evaluation of renal injury by isotope renography, arteriography or computerized tomography, leading to questions about appropriate management. The medical records of 9 documented cases of segmental thrombosis were reviewed. No specific diagnostic features were found on clinical examination or an initial excretory urogram. All 9 patients had associated injuries (an average of 2.0 per patient) and 2 died of these injuries. One patient had immediate surgical repair of a thrombosed posterior branch of the renal artery whereas the other 8 had nonoperative management. No hypertension was found on followup of the 5 available patients, and hypertension occurred in only 10 of 170 reported cases (6 per cent) of traumatic thrombosis or operative ligation of segmental branches. Traumatic thrombosis of a segmental renal artery branch initially should be managed nonoperatively.