Traumatically shattered kidney without urine extravasation or vascular amputation.
The American Association for the Surgery of Trauma (AAST) injury scoring scale is commonly used for genitourinary injuries. Normally, grade 4-5 lacerations of the kidney show involvement of the pelvicalyceal system (PCS) with urine extravasation (UE). We present a case of a 41-year-old woman who was hospitalised with macrohaematuria and retroperitoneal haematoma after severe blunt acceleration flank trauma. CT scan showed an extended laceration of the left kidney with separation of upper pole. This is the first case of an extended kidney laceration without UE due to rupture within the dichotomous PCS, which healed up after selective embolisation. If possible, severe renal bleeding should be treated with selective embolisation as an alternative to surgery. Any suspected involvement of the PCS should undergo retrograde ureteropyelography and urinary diversion.
Department of Urology, University Magdeburg, Magdeburg, Sachsen-Anhalt, Germany.
Johann Jakob
JJ
Wendler
Department of Radiology, University Magdeburg, Magdeburg, Sachsen-Anhalt, Germany.
Julian
J
Jürgens
Department of Urology, University Magdeburg, Magdeburg, Sachsen-Anhalt, Germany.
Martin
M
Schostak
Department of Urology, University Magdeburg, Magdeburg, Sachsen-Anhalt, Germany.
Uwe-Bernd
UB
Liehr
D000328:Adult; D004621:Embolization, Therapeutic; D005260:Female; D006406:Hematoma / Q000209:etiology / Q000628:therapy*; D006417:Hematuria / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000000981:diagnostic imaging / Q000293:injuries*; D011859:Radiography; D012187:Retroperitoneal Space; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*