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Renal Trauma During Laparotomy for Intra-abdominal Injury

Renal Trauma During Laparotomy for Intra-abdominal Injury Abstract The advantages of nonsurgical or surgical management of renal injuries are important when the renal trauma is found during a laparotomy for intra-abdominal injury. Blunt external trauma caused 85.5% of the renal injuries found during laparotomy in 194 patients. A large dose or infusion intravenous pyelogram on a modified operating table has allowed immediate evaluation of the renal Injury during a laparotomy. When the degree of renal injury was more severe, renal tissue and function were saved by early surgical management. In this group, lowered morbidity and a sharp reduction in delayed renal operations followed the introduction of immediate surgical management. The nephrectomy rate was 11%, which compares favorably with that of nonsurgical management. Clamping of the renal vessels prior to opening Gerota fascia prevented reactivation of hemorrhage and allowed for a deliberate operation with conservation of undamaged renal tissue. References 1. Cass AS, Ireland GW, Bressler E, et al: Modification of an operating room table for immediate radiographic evaluation of the urinary tract in acute severe trauma patients . J Urol 105:569-570, 1971. 2. Sargent JC, Marquardt CR: Renal injuries . J Urol 63:1-8, 1950. 3. Mertz JH, Wishard WN Jr, Nourse MH, et al: Injury of the kidney in children . JAMA 183:730-733, 1963.Crossref 4. Reid IS: Renal trauma in children: A ten-year review . Aust NZ J Surg 42:260-266, 1973.Crossref 5. Hale SD: Renal injuries. Read before the 25th annual meeting of Northeastern Section of the American Urological Association, Toronto, 1973. 6. Vermillion CD, McLaughlin AP III, Pfister RC: Management of blunt renal trauma . J Urol 106:478-484, 1971. 7. Nation EF, Massey BD: Renal trauma: Experience with 258 cases . J Urol 89:775-778, 1963. 8. Forsythe WE, Persky L: Comparison of ureteral and renal injuries . Am J Surg 97:558-562, 1959.Crossref 9. Slade N: Management of closed renal injuries . Br J Urol 43:639-645, 1971.Crossref 10. Glenn JF, Harvard BM: The injured kidney . JAMA 178:1189-1195, 1960.Crossref 11. Morrow JW, Mendez R: Renal trauma . J Urol 104:649-653, 1970. 12. Carlton CE Jr: Early operation in the management of blunt renal injuries , in Current Controversies of Urologic Management . Philadelphia, WB Saunders Co, 1972, pp 109-111. 13. Guerriero WG, Carlton CE Jr, Scott R Jr, et al: Renal pedicle injuries . J Trauma 11:53-62, 1971.Crossref 14. Morse TS, Smith JP, Howard WHR, et al: Kidney injuries in children . J Urol 98:539-547, 1967. 15. Scott R Jr, Carlton CE Jr, Ashmore AJ, et al: Initial management of nonpenetrating renal injuries: Clinical review of 111 cases . J Urol 90:535-540, 1963. 16. Scott R Jr, Carlton CE Jr, Goldman M: Penetrating injuries of the kidney: An analysis of 181 patients . J Urol 101:247-253, 1969. 17. Cass AS, Ireland GW: Comparison of the conservative and surgical management of the more severe degrees of renal trauma in multiple injured patient . J Urol 109:8-10, 1973. 18. Persky L, Forsythe W: Renal trauma in childhood . JAMA 182:709-712, 1962.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Renal Trauma During Laparotomy for Intra-abdominal Injury

Archives of Surgery , Volume 110 (8) – Aug 1, 1975

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Publisher
American Medical Association
Copyright
Copyright © 1975 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1975.01360140094019
Publisher site
See Article on Publisher Site

Abstract

Abstract The advantages of nonsurgical or surgical management of renal injuries are important when the renal trauma is found during a laparotomy for intra-abdominal injury. Blunt external trauma caused 85.5% of the renal injuries found during laparotomy in 194 patients. A large dose or infusion intravenous pyelogram on a modified operating table has allowed immediate evaluation of the renal Injury during a laparotomy. When the degree of renal injury was more severe, renal tissue and function were saved by early surgical management. In this group, lowered morbidity and a sharp reduction in delayed renal operations followed the introduction of immediate surgical management. The nephrectomy rate was 11%, which compares favorably with that of nonsurgical management. Clamping of the renal vessels prior to opening Gerota fascia prevented reactivation of hemorrhage and allowed for a deliberate operation with conservation of undamaged renal tissue. References 1. Cass AS, Ireland GW, Bressler E, et al: Modification of an operating room table for immediate radiographic evaluation of the urinary tract in acute severe trauma patients . J Urol 105:569-570, 1971. 2. Sargent JC, Marquardt CR: Renal injuries . J Urol 63:1-8, 1950. 3. Mertz JH, Wishard WN Jr, Nourse MH, et al: Injury of the kidney in children . JAMA 183:730-733, 1963.Crossref 4. Reid IS: Renal trauma in children: A ten-year review . Aust NZ J Surg 42:260-266, 1973.Crossref 5. Hale SD: Renal injuries. Read before the 25th annual meeting of Northeastern Section of the American Urological Association, Toronto, 1973. 6. Vermillion CD, McLaughlin AP III, Pfister RC: Management of blunt renal trauma . J Urol 106:478-484, 1971. 7. Nation EF, Massey BD: Renal trauma: Experience with 258 cases . J Urol 89:775-778, 1963. 8. Forsythe WE, Persky L: Comparison of ureteral and renal injuries . Am J Surg 97:558-562, 1959.Crossref 9. Slade N: Management of closed renal injuries . Br J Urol 43:639-645, 1971.Crossref 10. Glenn JF, Harvard BM: The injured kidney . JAMA 178:1189-1195, 1960.Crossref 11. Morrow JW, Mendez R: Renal trauma . J Urol 104:649-653, 1970. 12. Carlton CE Jr: Early operation in the management of blunt renal injuries , in Current Controversies of Urologic Management . Philadelphia, WB Saunders Co, 1972, pp 109-111. 13. Guerriero WG, Carlton CE Jr, Scott R Jr, et al: Renal pedicle injuries . J Trauma 11:53-62, 1971.Crossref 14. Morse TS, Smith JP, Howard WHR, et al: Kidney injuries in children . J Urol 98:539-547, 1967. 15. Scott R Jr, Carlton CE Jr, Ashmore AJ, et al: Initial management of nonpenetrating renal injuries: Clinical review of 111 cases . J Urol 90:535-540, 1963. 16. Scott R Jr, Carlton CE Jr, Goldman M: Penetrating injuries of the kidney: An analysis of 181 patients . J Urol 101:247-253, 1969. 17. Cass AS, Ireland GW: Comparison of the conservative and surgical management of the more severe degrees of renal trauma in multiple injured patient . J Urol 109:8-10, 1973. 18. Persky L, Forsythe W: Renal trauma in childhood . JAMA 182:709-712, 1962.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Aug 1, 1975

References