title: Evaluation of need for angioembolization in blunt renal injury: discontinuity of Gerota's fascia has an increased probability of requiring angioembolization.
abstract: BACKGROUND
  Angioembolization is an effective adjunct in the management of high-grade renal injuries not surgically treated. However, in some cases, the bleeding may stop spontaneously, without the need for embolization. The aim of this study was to define the characteristics of patients who need angioembolization for high-grade blunt renal injuries (BRIs).
  
  
  METHODS
  Patients with BRIs between January 2004 and May 2008 were retrospectively reviewed. Patients with contrast extravasation on computed tomographic scans who then underwent angiography were enrolled. Demographics, injury severity scores, abbreviated injury scale scores, amounts of blood transfused, and need for angioembolization were analyzed.
  
  
  RESULTS
  Twenty-six patients were enrolled. Patients with discontinuity of Gerota's fascia and pararenal hematoma expansion in BRIs required angioembolization at a higher rate. Furthermore, these patients displayed higher injury severity scores and abbreviated injury scale scores. Five patients experienced complications.
  
  
  CONCLUSIONS
  In patients with BRIs, discontinuity of Gerota's fascia and pararenal hematoma expansion seemed to be associated with the need for angioembolization. Early angioembolization should be considered in patients with severe associated trauma with BRIs.
authors.affiliation: Trauma and Emergency Center, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chih-Yuan
authors.initials: CY
authors.lastname: Fu
authors.forename: Shih-Chi
authors.initials: SC
authors.lastname: Wu
authors.forename: Ray-Jade
authors.initials: RJ
authors.lastname: Chen
authors.forename: Yung-Fang
authors.initials: YF
authors.lastname: Chen
authors.forename: Yu-Chun
authors.initials: YC
authors.lastname: Wang
authors.forename: Ping-Kuei
authors.initials: PK
authors.lastname: Chung
authors.forename: Hung-Chang
authors.initials: HC
authors.lastname: Huang
authors.forename: Jui-Chien
authors.initials: JC
authors.lastname: Huang
authors.forename: Chih-Wei
authors.initials: CW
authors.lastname: Lu
mesh_terms: D000328:Adult; D000465:Algorithms; D000792:Angiography; D004621:Embolization, Therapeutic; D005119:Extravasation of Diagnostic and Therapeutic Materials; D005205:Fascia / Q000293:injuries*; D005260:Female; D006406:Hematoma / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D015601:Injury Severity Score; D007668:Kidney / Q000293:injuries*; D008297:Male; D018579:Patient Selection; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000175:diagnosis / Q000628:therapy*