renal artery injury - blunt

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What I would depend upon 
1. whether the renal artery occlusion was secondary to a lacerated renal  
artery or a an intimal flap with occlusion.
2. The time from injury to diagnosis
 
If i saw a central perinephric hematoma, i would diagnose a renal artery  
laceration and would secure the occlusion to assure that recanalization did not  
result in a false aneurysm or recurrent hemorrhage.
 
If i saw a renal artery occlusion and NO perinephric hematoma, then I would  
diagnose intimal tear causing occlusion. If time from trauma to diagnosis 
wasn't  too long, I would consider some thrombolytics and then stent graft the 
renal  artery. If the time to diagnosis was long and there was no perinephric 
hematoma,  I would leave it alone
 
sal sclafani
 
 
9/22/2007 12:49:14 P.M. W. Europe Daylight Time,  
errington at erringtonthompson.com writes:

45 yo  dude on his motorcycle.  He somehow runs into a limo (probably  ruining
the date).  He is confused and combative.  He undergoes  rapid sequence
intubation.  CT scans reveal an occluded renal  artery.  The kidney does not
light up on the right.  The left  kidney is fine.  Sal and others, is there
any reason to try to have IR  to occlude that right renal artery to  prevent
recannulation?

Thanks,

Errington C. Thompson, MD,  FACS, FCCM
Trauma/Surgical Critical Care
Mission Hospital
Asheville,  NC
Author - A Letter to  America
www.whereistheoutrage.net


 



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