[Diagnostic and therapeutic strategy in injuries of the kidney. Apropos of a series of 248 cases]

Ann Urol (Paris). 1988;22(4):273-7.
[Article in French]

Abstract

The analysis of a series of 248 cases led to the following conclusions: intravenous pyelography, together with nephrotomography and ultrasonography represent, the pillars of emergency assessment; computed tomography, performed systematically since 1985, is the most appropriate examination for the precise assessment of the lesions in a functioning kidney; arteriography is still essential in cases of urographically silent kidneys. The choice of therapeutic approach essentially depends on the type of the lesion: severe parenchymal lesions (type III) (58 cases) and certain cases of type II trauma (25 cases) underwent a deferred emergency operation which was as conservative as possible; pedicle lesions (type IV) and serious haemorrhagic lesions required emergency surgery (11 cases); type I or type II lesions with moderate hematomas were usually treated by simple observation (145 cases); cases of trauma seen at the stage of sequelae (8 cases) sometimes required a surgical solution (arteriovenous fistula, segmental ischaemia of the parenchyma with hypertension, encysted urinoma).

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Angiography
  • Child
  • Female
  • Humans
  • Kidney / diagnostic imaging
  • Kidney / injuries*
  • Male
  • Middle Aged
  • Tomography, X-Ray
  • Tomography, X-Ray Computed
  • Ultrasonography
  • Wounds, Nonpenetrating / diagnosis*
  • Wounds, Nonpenetrating / diagnostic imaging
  • Wounds, Nonpenetrating / therapy