Attempted nonoperative management of blunt renal lacerations extending through the corticomedullary junction: the short-term and long-term sequelae.
A total of 50 patients who sustained a renal laceration extending through the corticomedullary junction following blunt trauma underwent an attempt at nonoperative (expectant) management of the urological injury. Of the patients 18% could not be stabilized and they subsequently underwent emergency laparotomy. Among our stabilized patients 2 major categories existed: 1) 30 patients with vascularized renal fragments and 2) 11 in whom a fragment of the kidney was devascularized. A statistically significant difference in the length of hospital stay (p equals 0.01) and the need for delayed surgical intervention (p less than 0.001) was noted between the 2 groups. We recommend that the physician must have a heightened awareness of probable complications in patients with major renal lacerations associated with devitalized fragments and suggest that early surgical management should be considered.
Husmann
D A
DA
University of Texas Southwestern, Dallas.
Morris
J S
JS
D001794:Blood Pressure; D006801:Humans; D007668:Kidney / Q000293:injuries* / Q000473:pathology; D007672:Kidney Cortex / Q000293:injuries / Q000473:pathology; D007679:Kidney Medulla / Q000293:injuries / Q000473:pathology; D013997:Time Factors; D014949:Wounds, Nonpenetrating / Q000473:pathology / Q000628:therapy