[Evaluation and treatment of closed renal trauma]

Renal trauma accounts for more than 50% of all genitourinary trauma cases, nearly 90% of them corresponding to blunt trauma. Incidence is higher in male (3:1 ratio); is more frequent between the second and third decades; and predominantly affects the left side. Our group analyzed 89 cases of blunt renal trauma seen in our service between 1983 and 1996 with the purpose of determining the choice imaging studies, indications and type of management. Based on severity, injuries were rated in 5 grades using the classification of the Organic Injuries Survey Committee (OIS) from the American Association of Surgery in Trauma (AAST). We analyzed the etiology, clinical findings, prior renal conditions, associated injuries, radiologic studies and treatment instituted. CAT was considered the choice diagnostic technique for trauma rating since it permits greater definition of renal injury grade, as well as the associated abdominal and thoracic injuries. Most renal traumas were mild in severity, and evolved favourably with conservative treatment. In renal trauma grades IV and V, surgery is the recommended therapeutic approach, always preferring the most conservative criteria.