Delayed nephrectomy in grade V renal injury with two interesting anatomic variations.
The decision to perform early nephrectomy in hemodynamically stable grade V injury rather than to provide supportive nonoperative care is not universally accepted. The management of isolated grade V renal injury, as well as the management of coexisting abdominal trauma that requires operative intervention, is an area of controversy. We present the case of a grade V renal injury that was initially managed expectantly at a level I trauma center. After transfer to our facility, nephrectomy was performed. The case illustrates the merit of prompt definitive surgical treatment.
Richter
E R
ER
General Surgery Service, Department of Surgery, Walter Reed Army Medical Center, Washington, DC 20307, USA.
Shriver
C D
CD
D000328:Adult; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000293:injuries*; D007813:Laparotomy; D008297:Male; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000601:surgery*; D009392:Nephrectomy; D012077:Renal Artery / Q000002:abnormalities; D012082:Renal Veins / Q000002:abnormalities; D012421:Rupture; D012865:Skiing / Q000293:injuries*; D013154:Spleen / Q000000981:diagnostic imaging / Q000293:injuries; D013156:Splenectomy; D014057:Tomography, X-Ray Computed; D014950:Wounds, Penetrating / Q000000981:diagnostic imaging / Q000601:surgery*