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Penetrating ureteric injuries

K Azimuddin1, D Milanesa, R Ivatury

  • 1Department of Surgery, Lincoln Medical Center, Bronx, NY 10451, USA.

Injury
|November 14, 1998
PubMed
Summary
This summary is machine-generated.

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Penetrating ureteric injuries are rare but often severe. Intraoperative exploration is crucial for diagnosis, as imaging and hematuria are unreliable indicators of ureteral damage.

Area of Science:

  • Urology
  • Trauma Surgery
  • Surgical Outcomes

Background:

  • Ureteral injuries from penetrating trauma are uncommon.
  • Accurate preoperative diagnosis is challenging.
  • Associated injuries frequently lead to critical illness.

Purpose of the Study:

  • To review the experience with penetrating ureteral injuries.
  • To evaluate diagnostic methods and treatment outcomes.
  • To identify factors affecting anastomotic healing.

Main Methods:

  • Retrospective review of 21 cases of ureteral injury.
  • Analysis of injury types, diagnostic methods, and surgical interventions.
  • Assessment of complications and healing of ureteral anastomoses.

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Main Results:

  • 19 gunshot wounds and 2 stab wounds caused ureteral injuries.
  • Hematuria present in 66%, IVU diagnostic in only 14%.
  • 14% anastomotic leak rate; no adverse effect from contamination or hypotension.

Conclusions:

  • Intraoperative exploration is the definitive method for diagnosing ureteral injuries.
  • Penetrating ureteral trauma requires prompt surgical management.
  • Ureteral anastomoses can heal successfully despite contamination and hypotension.