[Diagnostic and therapeutic strategy in injuries of the kidney. Apropos of a series of 248 cases].
The analysis of a series of 248 cases led to the following conclusions: intravenous pyelography, together with nephrotomography and ultrasonography represent, the pillars of emergency assessment; computed tomography, performed systematically since 1985, is the most appropriate examination for the precise assessment of the lesions in a functioning kidney; arteriography is still essential in cases of urographically silent kidneys. The choice of therapeutic approach essentially depends on the type of the lesion: severe parenchymal lesions (type III) (58 cases) and certain cases of type II trauma (25 cases) underwent a deferred emergency operation which was as conservative as possible; pedicle lesions (type IV) and serious haemorrhagic lesions required emergency surgery (11 cases); type I or type II lesions with moderate hematomas were usually treated by simple observation (145 cases); cases of trauma seen at the stage of sequelae (8 cases) sometimes required a surgical solution (arteriovenous fistula, segmental ischaemia of the parenchyma with hypertension, encysted urinoma).
Piechaud
T
T
Service d'Urologie, Hôpital Pellegrin Tripode, Bordeaux.
Ferrière
J M
JM
Carles
J
J
Grenier
N
N
Le Guillou
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography; D002648:Child; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D014056:Tomography, X-Ray; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy
Stratégie diagnostique et thérapeutique dans les traumatismes du rein. A propos d'une série de 248 cas.