Successful repair of combined renal pedicle injury: a new application of the ex vivo "bench" technique.
A case of avulsion injury to the renal pedicle caused by blunt trauma in a 22-year-old man is reported. Mild peritoneal irritation, microscopic hematuria, a nonsecreting left kidney on intravenous pyelography, and an intimal tear of the left renal artery were demonstrated on renal angiography and suggested an injury to the pedicle of the left kidney. Explorative laparotomy revealed minor lacerations of the ileal mesentery and an intimal tear of the renal artery with complete transection of the renal pelvis in its intrarenal portion. The combined vascular and ureteral injuries were repaired by the ex vivo "bench" technique. The kidney was reimplanted into the left iliac fossa. Intravenous pyelography performed one month postoperatively revealed an immediate secretion of the left kidney. One year later the patient was normotensive, with good function of the reimplanted kidney. This is the first reported application of the ex vivo "bench" technique and autotransplantation of the kidney to the iliac fossa in a trauma case.
D000328:Adult; D006801:Humans; D007682:Kidney Pelvis / Q000293:injuries; D016030:Kidney Transplantation; D008297:Male; D008643:Mesentery / Q000293:injuries; D008722:Methods; D012077:Renal Artery / Q000293:injuries*; D014182:Transplantation, Autologous; D014513:Ureter / Q000293:injuries; D014949:Wounds, Nonpenetrating / Q000601:surgery*