[Surgical management of blunt renal trauma]

From 1986 to 1990, 26 patients with blunt renal trauma were hospitalized and received surgery in this Hospital. Included were 23 males and 3 females with a mean age of 28.6 years (range: 5 to 82). The mean duration of follow-up was 37 months. The severity of renal injury was classified by using the renal injury scale which was published by the Organ Injury Scaling (O.I.S.) Committee of the American Association for the Surgery of Trauma (A.A.S.T.) in 1989. According to operative findings, the renal injuries of the 26 cases were classified as follows: Grade I, 3 cases; Grade II, 4 cases; Grade III, 2 cases; Grade IV, 6 cases; and Grade V, 12 cases. One case had bilateral renal injuries. Among the patients, four were treated with drainage. Three cases underwent repair and drainage. One case was treated with partial nephrectomy. Nineteen cases underwent nephrectomy. The mortality rate was 7.6% and the morbidity rate, 15.2%. The most frequent postoperative complications related to renal injury in the patients who survived initial operation were intra-abdominal abscesses (3.8%), small bowel obstruction (3.8%), pulmonary infection (3.8%) and pancreatitis (3.8%).