The diagnosis and management of renal trauma

Abstract

Background: Renal trauma is less common but often occurs in polytrauma. Most trauma is blunt and the severity of the injury varies in different circumstances. Assessment: There is a series of features that should prompt investigation but none are reliably seen in all trauma cases and a low threshold for suspecting renal injury should be taken. A urine dip is essential. Investigation: Computerised tomography is the main modality. Follow-up imaging may be used if complications arise and ultrasound may be used in some cases. Management: Approaches include surgical, radiological and conservative. The latter has been achieved in all grades but intervention will be required in haemodynamic instability. Complications: Haemorrhage, infection and urine extravasation are common and require intervention. There are many long-term complications and hypertension can occur by a variety of mechanisms.