A unified concept of renal trauma.

Of 115 cases of renal trauma 75 injuries were blunt and 40 were penetrating. Primary exploration was done in20 per cent of the patients with blunt injuries and in 100 per cent of those with penetrating injuries. A reparative procedure was done in 60 per cent of the patients operated on for blunt trauma and in 73 per cent of those operated upon for penetrating trauma. Only 3 per cent of the patients with blunt injury and 28 per cent of those with penetrating injury required a nephrectomy. We have concluded that renal injuries should be classified by type and extent rather than by etiology, that the extent of injury should be determined and not surmised, and that the management of renal trauma is a function of the extent of injury and the over-all status of the patient. In addition, the non-operative management of an inadequately defined renal injury cannot be considered conservative management.