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Kidney Injury

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Selective nonoperative management of penetrating abdominal solid organ injuries.
Demetriades D, Hadjizacharia P, Constantinou C, Brown C, Inaba K, Rhee P, Salim A.
Ann Surg. 2006 Oct;244(4):620-8.

Rationale for inclusion: LA County presented a series of 152 patients sustaining penetrating abdominal solid organ injury in which nonoperative management was successful when used selectively, challenging the standard practice that all penetrating organ injury mandates exploration.

Citations - 117 (as of November 2016)

Predictors of the need for nephrectomy after renal trauma.
Davis KA, Reed RL 2nd, Santaniello J, Abodeely A, Esposito TJ, Poulakidas SJ, Luchette FA.
J Trauma. 2006 Jan;60(1):164-9; discussion 169-70.

Rationale for inclusion: A single center retrospective review, this manuscript identified that injury severity, grade of injury, hemodynamic instability, and transfusion requirements all predict need for nephrectomy after injury, with penetrating mechanisms requiring nephrectomy more commonly than blunt mechanisms of injury.

Citations - 64 (as of July 2017)

Nonoperative treatment of blunt injury to solid abdominal organs: a prospective study.
Velmahos GC, Toutouzas KG, Radin R, Chan L, Demetriades D.
Arch Surg. 2003 Aug;138(8):844-51.

Rationale for inclusion: This study identified 4 independent factors associated with failure of nonoperative management of solid organ injury (liver, kidney, and spleen), including non-liver injury, positive ultrasound, >300mL of hemoperitoneum on CT, and need for transfusion.  

Citations - 278 (as of July 2017)

Validation of the American Association for the Surgery of Trauma organ injury severity scale for the kidney.
Santucci RA, McAninch JW, Safir M, Mario LA, Service S, Segal MR.
J Trauma. 2001 Feb;50(2):195-200.

Rationale for inclusion: This study validated the AAST injury scale for renal injury, supporting its correlation with need for repair or nephrectomy.

Citations - 215 (as of July 2017)

Outcome after major renovascular injuries: a Western trauma association multicenter report.
Knudson MM, Harrison PB, Hoyt DB, Shatz DV, Zietlow SP, Bergstein JM, Mario LA, McAninch JW.
J Trauma. 2000 Dec;49(6):1116-22.

Rationale for inclusion: The results of this WTA multi-center report concluded that factors associated with poor outcome following conservative management of major renovascular injuries include blunt mechanism, high grade injury (grade V), and attempted vascular repair, identifying patients who may be better treated with initial nephrectomy.

Citations - 135 (as of July 2017)

Selective nonoperative management of blunt grade 5 renal injury.
Altman AL, Haas C, Dinchman KH, Spirnak JP.
J Urol. 2000 Jul;164(1):27-30; discussion 30-1.

Rationale for inclusion: Using a small series, this study supports the conservative management of grade V renal lacerations in patients presenting without hemodynamic compromise.

Citations - 157 (as of July 2017)

Nonoperative treatment of major blunt renal lacerations with urinary extravasation.
Matthews LA, Smith EM, Spirnak JP.
J Urol. 1997 Jun;157(6):2056-8.

Rationale for inclusion: This series concluded that major renal lacerations with urinary extravasation can be safely managed nonoperatively with renal salvage, but may require delayed intervention including stenting or percutaneous drainage.

Citations - 178 (as of July 2017)

Radiographic assessment of renal trauma: our 15-year experience.
Miller KS, McAninch JW.
J Urol. 1995 Aug;154(2 Pt 1):352-5.

Rationale for inclusion: This study used a retrospective analysis of 2254 patients to determine that imaging is not necessary to rule out renal trauma in patients with microscopic hematuria without significant intraabdominal injuries or the presence of shock.  

Citations - 228 (as of July 2017)

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