RENAL LACERATION.
Trauma is an unbiased occurrence that affects any person of any age, sex, or ethnicity.
Clinical findings that can exist in a patient with renal trauma include hematuria, flank hematoma, lower rib fractures, and vital sign instability, such as hypotension.
General patients with blunt trauma and abdominal symptoms, hypotension or an appreciably depressed level of consciousness consistently undergo abdominal and pelvic CT, which serves as the most comprehensive diagnostic tool for evaluating such a patient.
Grading of the renal laceration is important in management of the patient.
GRADING
- Grade 1
Hematuria with normal imaging studies
Contusions
Nonexpanding sub capsular hematomas
- Grade 2
Nonexpanding perinephric hematomas confined to the retroperitoneum
Superficial cortical lacerations less than 1 cm in depth without collecting system injury
- Grade 3
Renal lacerations greater than 1 cm in depth that do not involve the collecting system
- Grade 4
Renal lacerations extending through the kidney into the collecting system
Injuries involving the main renal artery or vein with contained hemorrhage
Segmental infarctions without associated lacerations
Expanding subcapsular hematomas compressing the kidney
- Grade 5
Shattered or devascularized kidney
Ureteropelvic avulsions
Complete laceration or thrombus of the main renal artery or vein