title: Penetrating trauma to the kidney and Meckel's Diverticulum in a patient with unilateral renal agenesis.
abstract: BACKGROUND
  Emergency laparotomy for abdominal gunshot wounds is frequently performed in South Africa and remains associated with significant morbidity and mortality. The occurrence of congenital anomalies during surgery is an unexpected finding and presents a major challenge.
  
  
  METHODS
  The successful management of a haemodynamically unstable 26-year-old man with unilateral renal agenesis, concomitant right renal and hepatic injuries, and a transected Meckel's Diverticulum following an abdominal gunshot wound is presented.
  
  
  CONCLUSIONS
  Intraoperative decision-making is difficult when congenital visceral anomalies form part of the injury complex in trauma. Basic principles of damage control surgery that include initial exploration, secondary resuscitation and definite operation must be adhered to. Repair of complex injuries are delayed until the definitive laparotomy. The presence of one congenital anomaly should alert the surgeon to the possibility of further anomalies.
  
  
  CONCLUSIONS
  Although congenital visceral anomalies are spectacular findings at laparotomy, they should not distract the trauma surgeon. Adhering to damage control surgery principles and careful inspection of the peritoneal cavity for further abnormalities remain the mainstay of successful management.
authors.affiliation: Trauma Centre and Department of Surgery, University of Cape Town, Groote Schuur Hospital, Anzio Road, Observatory, 7925 Cape Town, South Africa. Electronic address: sanjusobnach@hotmail.com.
authors.forename: Sanju
authors.initials: S
authors.lastname: Sobnach
authors.affiliation: Trauma Centre and Department of Surgery, University of Cape Town, Groote Schuur Hospital, Anzio Road, Observatory, 7925 Cape Town, South Africa.
authors.forename: Rajshree
authors.initials: R
authors.lastname: Segobin
authors.affiliation: Trauma Centre and Department of Surgery, University of Cape Town, Groote Schuur Hospital, Anzio Road, Observatory, 7925 Cape Town, South Africa.
authors.forename: Andrew
authors.initials: A
authors.lastname: Nicol
authors.affiliation: Trauma Centre and Department of Surgery, University of Cape Town, Groote Schuur Hospital, Anzio Road, Observatory, 7925 Cape Town, South Africa.
authors.forename: Sorin
authors.initials: S
authors.lastname: Edu
authors.affiliation: Department of Surgery, University of Cape Town, Groote Schuur Hospital, Anzio Road, Observatory, 7925 Cape Town, South Africa.
authors.forename: Delawir
authors.initials: D
authors.lastname: Kahn
authors.affiliation: Trauma Centre and Department of Surgery, University of Cape Town, Groote Schuur Hospital, Anzio Road, Observatory, 7925 Cape Town, South Africa.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Navsaria
keywords: Meckel’s Diverticulum; Penetrating trauma; Renal agenesis