1.Diagnosis and treatment of traumatic renal infarction
Jiansong WANG ; Zhe LIU ; Qiang ZHOU ; Yixing DUAN ; Wuxiong YUAN ; Zhiyong GAO ; Wanrui WU
Chinese Journal of Trauma 2014;30(6):516-519
Objective To investigate the diagnosis and treatment methods of traumatic renal infarction.Methods A retrospective analysis was performed on 6 cases of traumatic renal infarction treated between September 2008 and February 2013.There were 5 males and 1 female,at age of 5-65 years (average,36.2 years).Causes of injury included vehicle collisions in 4 cases and high falls in 2.Out of 6 cases,segmental renal infarction was identified in 2 and total infarction in 4.According to American Association for the surgery of trauma renal trauma grading system,2 cases were classified to grade Ⅳ and 4 to grade Ⅴ.Results Three cases were managed conservatively,which showed segmental infarction in 1 case and total infarction in 2.Three cases underwent surgical exploration,followed by partial nephrectomy in 1 case,left kidney removal plus partial pancreectomy in 1 and right kidney removal in 1.There were no major complications intraoperatively or postoperatively and no cases received blood transfusion.Period of follow-up was 3-34 months.In conservative management,there were no renal atrophies in segmental renal infarction cases and some degree of atrophies in total renal infarction cases,but none presented with arterial hypertension.Conclusions Enhanced CT is the preferred diagnostic tool for evaluation of traumatic renal infarction.Conservative therapy is the optimal option for most cases,but nephrectomy is reserved for cases of infection or renal hypertension.