Management of blunt renal trauma.

The management of major renal lacerations after blunt trauma is still a matter of controversy. In this study, conservative treatment of major renal lacerations failed in 7 of 18 patients, leading to delayed surgery. Urography after blunt trauma was abnormal in 97% of patients with severe renal injury but a normal urogram did not exclude severe renal injury. Computed tomography had a greater degree of accuracy than urography and ultrasonography in determining the extent of the injury and was more practical to perform than angiography. The results indicate that patients with significant extrarenal leakage on urography, angiography or CT should receive immediate surgical management.