Nonoperative treatment of major blunt renal lacerations with urinary extravasation.
OBJECTIVE
We determined whether nonoperative treatment of major renal lacerations with urinary extravasation adversely affects patient outcome.


METHODS
We reviewed all nonoperatively treated patients who presented between 1983 and 1994 with blunt renal trauma with major lacerations on initial staging computerized tomography. Patients with major lacerations associated with (31) and without (15) extravasation were compared for complications, blood transfusions and length of hospital stay.


RESULTS
Urinary extravasation spontaneously resolved in 27 of 31 patients (87.1%), while 4 (12.9%) required a ureteral stent for persistent extravasation. No complications occurred in patients without extravasation. Mean hospitalization was 8.3 and 7.7 days for patients with isolated renal injuries with and without extravasation, respectively. Blood transfusions were required in 4 patients with and none without extravasation.


CONCLUSIONS
Nonoperative treatment of major renal lacerations with urinary extravasation is safe and effective. Although delayed intervention may be required, complications can often be treated with endourological or percutaneous methods.
Matthews
L A
LA
Case Western Reserve University, School of Medicine, MetroHealth Medical Center, Cleveland, Ohio, USA.
Smith
E M
EM
Spirnak
J P
JP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000293:injuries* / Q000503:physiopathology; D008875:Middle Aged; D012189:Retrospective Studies; D014556:Urine; D014949:Wounds, Nonpenetrating / Q000503:physiopathology* / Q000628:therapy*