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ABDOMINAL TRAUMA
 

 

 

Management

Goals of management :

  • minimize morbidity & mortality
  • preserve renal function
Surgical vs Non-operative management:

Most grade I - IV injuries can be treated conservatively, thus avoiding unnecessary surgery.
Surgery is indicated for :

  • Vascular (renal pedicle) injury
  • Shattered kidney
  • Expanding or pulsatile haematoma
  • Shocked polytrauma patient

Introduction
Case Presentation
Initial Evaluation
Radiology
Grading
Management
Surgical Technique
Conclusions

 

  Relative indications for surgery include :

  • A devitalized renal segment in the presence of other abdominal injuries
  • Persistent extravasation
  • Loculated collections
  • Incomplete grading (CT or angiography)
9% of kidney injuries will require surgical exploration, and of these there is on average an 11% nephrectomy rate.
Most nephrectomies are for haemorrhage, and 61% of nephrectomies are for renovascular injury.
Patients underggoing nephrectomy tend to be more severely injured.