[Diagnosis and therapy of kidney traumas]

A dynamic helical CT scan following initial ultrasound provides reliable radiological staging for kidney traumas and immediate diagnosis of most abdominal injuries. It also proves useful for pediatric traumas. Using mainly CT data we apply a classification system proposed by the American Association for Surgery of Trauma (grade I-V). The diagnostic steps and subsequent management are demonstrated by flow-chart. Most renal traumas may be treated conservatively but persistent bleeding or persistent urinary extravasation may necessitate surgical intervention. In cases of exploration of the kidney, the use of fibrin adhesive, alloplastic mesh capsule and DJ stents enables the reconstruction of the kidney. Exploration of the renal injury should never be omitted if urgent laparotomy is indicated for associated injuries.