Pfitzenmaier J, Buse S, Haferkamp A, Pahernik S, Djakovic N, Hohenfellner M
Urologische Universitätsklinik, Heidelberg, Germany.
Unfallchirurg. 2009 Mar;112(3):317-25; quiz 326. doi: 10.1007/s00113-009-1595-0.
Most renal injuries in industrialized countries are caused by blunt trauma to the kidney. The management of renal trauma has always been and will always be controversial. Conservative management and aggressive intervention both have their proponents, but conservative treatment is generally favored nowadays, even in the case of grade IV/(V) trauma. Urinary diversion by nephrostomy tube or ureteral stenting is not mandatory in most cases because the extravasation resolves in up to 90% of cases. Overall, there is a tendency toward a multimodal approach in which the interventional radiologist is more and more often part of the team that takes care of the patient with high-grade injuries. The success rate of angioembolization is 70-80%. Long-term consequences can be hypertension or diminished kidney function.
