Renal trauma in rural Virginia

We analyzed the cause and nature of renal injuries in a rural environment, and the results of a conservative management program. Over a 10-year period there were 148 patients with nonpenetrating renal injuries and seven with penetrating renal injuries. Nine of the patients with nonpenetrating injuries (6%) had major renal parenchymal injuries and were observed. None required operation and followup in eight of nine suggested no renal functional impairment. Six patients with penetrating injuries underwent exploration and four required nephrectomy for major renal parenchymal or renal pedicle injuries. We conclude that a conservative approach to nonpenetrating minor and major renal parenchymal injuries may be successful.