Abstract
Between 1983 and 1993, 198 patients (141 male, 57 female, mean age 26 years) with renal trauma were treated at the Division of Urology in Treviso, Italy. The causes of renal trauma were mainly traffic accidents (66.1%) and sports (13.6%). 39.3% of cases had concomitant skeletal (29.7%), respiratory, spleen, hepatic and peripheral nervous system (9.6%) injuries. Diagnosis was mostly done with ultrasound and abdominal CT; only two cases required an arteriography. 173 cases (82.3%) received conservative treatment, while in 25 patients (17.7%) surgical procedure was necessary. In 17 (68%) of these patients organ preserving surgery was possible; only in 8 (32%) was nephrectomy required. Analysis of postoperative complications after reconstructive surgical therapy showed that with medical therapy there were complications in 47% of the cases with grade III lesions; in patients who underwent surgical repair: 1 sectorial deficiency and 1 “scar” without sectorial deficiency (12%). Hemodynamically unstable patients require immediate surgical therapy, while hemodynamically stable conditions permit a conservative attitude with a complete study of the kidney and delayed surgery if there are serious lesions. From Authors’ data, surgical repair assures a reduced percentage of late complications.
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