Evaluation of need for angioembolization in blunt renal injury: discontinuity of Gerota's fascia has an increased probability of requiring angioembolization.
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.
Fu
Chih-Yuan
CY
Trauma and Emergency Center, China Medical University Hospital, Taichung, Taiwan.
Wu
Shih-Chi
SC
Chen
Ray-Jade
RJ
Chen
Yung-Fang
YF
Wang
Yu-Chun
YC
Chung
Ping-Kuei
PK
Huang
Hung-Chang
HC
Huang
Jui-Chien
JC
Lu
Chih-Wei
CW
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*