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Endovascular management of grade V blunt renal trauma with associated splenic injury

Abstract

Background. A 15-year-old boy presented to hospital with tenderness in his left loin and hypochondrium, and frank hematuria; he was hemodynamically stable. The patient was overweight and had fallen onto his left flank from his bicycle 2 h previously.

Investigations. Physical examination, routine blood tests, contrast-enhanced CT of the abdomen and pelvis, renal MRI and percutaneous transfemoral angiography.

Diagnosis. Grade V blunt renal trauma, grade IV splenic injury and left renal vein thrombosis.

Management. The patient received conservative management with supportive measures followed by percutaneous transfemoral angiography and embolization of the injured left kidney. He recovered well and was able to resume normal activities.

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Figure 1: Significant injury in the left kidney and spleen of a 15-year-old boy after falling from his bicycle.
Figure 2: Follow-up MRI of the patient 4 weeks after discharge from hospital.

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Sahai, A., Cuthbert, F., Niekrash, R. et al. Endovascular management of grade V blunt renal trauma with associated splenic injury. Nat Rev Urol 6, 335–337 (2009). https://doi.org/10.1038/nrurol.2009.79

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