[Stab wounds of the kidney: conservative management. Two new cases and review of the literature].
BACKGROUND
Stab wounds of the kidney have traditionally been managed by open surgery. Nowadays the conservative management of stab wounds injuries is extended in order to avoid unnecessaries nephrectomies and laparotomies without increasing morbidity and mortality. Although there is no a strong evidence to recommend when to operate or what sort of follow up we must do.


METHODS
We present two new cases of stab wounds injuries managed conservatively. We performed a systematic review of the literature.


RESULTS
Both patients evolved favorably although one of them presented hematuria 7 days after the traumatism and we performed an embolization of an arteriovenous fistula. Most of the articles are based on series of cases or retrosprospective studies.


CONCLUSIONS
The diagnosis and staging of stab wounds of the kidney must be done with clinic and CT scan. Conservative management is required when the patient is not hemodinamically unstable and injuries do not require inmediate repair. These patients require a long-term follow up to prevent the appearance of complications. Randomized prospective multicenter trials are needed to support the optimum management for each kidney injury degree.
Caballero Romeu
Juan P
JP
Servicio de Urología, Hospital General Universitario de Alicante, España. juanpablocaballero@gmail.com
Megías Garrigós
Julián
J
Leivar Tamayo
Asier
A
Galiano Baena
Juan F
JF
Pérez Tomás
Carla
C
Herrero Polo
Enrique
E
D000293:Adolescent; D000328:Adult; D006801:Humans; D007668:Kidney / Q000293:injuries*; D008297:Male; D014951:Wounds, Stab / Q000628:therapy*