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

Nature Reviews Urology volume 6, pages 335–337 (2009)Cite this article

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.

References

  1. Baverstock, R., Simons, R. & McLoughlin, M. Severe blunt renal trauma: a 7-year retrospective review from a provincial trauma centre. Can. J. Urol. 8, 1372–1376 (2001).

    CAS  PubMed  Google Scholar 

  2. Meng, M. V., Brandes, S. B. & McAninch, J. W. Renal trauma: indications and techniques for surgical exploration. World J. Urol. 17, 71–77 (1999).

    Article  CAS  Google Scholar 

  3. Moore, E. E. et al. Organ injury scaling: spleen, liver, and kidney. J. Trauma 29, 1664–1666 (1989).

    Article  CAS  Google Scholar 

  4. Lynch, T. H. et al. EAU guidelines on urological trauma. Eur. Urol. 47, 1–15 (2005).

    Article  PubMed  Google Scholar 

  5. Santucci, R. A. et al. Evaluation and management of renal injuries: consensus statement of the renal trauma subcommittee. BJU Int. 93, 937–954 (2004).

    Article  CAS  PubMed  Google Scholar 

  6. Altman, A. L., Haas, C., Dinchman, K. H. & Spirnak, J. P. Selective nonoperative management of blunt grade 5 renal injury. J. Urol. 164, 27–30 (2000).

    Article  CAS  PubMed  Google Scholar 

  7. Matthews, L. A., Smith, E. M. & Spirnak, J. P. Nonoperative treatment of major blunt renal lacerations with urinary extravasation. J. Urol. 157, 2056–2058 (1997).

    Article  CAS  PubMed  Google Scholar 

  8. Matthews, L. A. & Spirnak, J. P. The nonoperative approach to major blunt renal trauma. Semin. Urol. 13, 77–82 (1995).

    CAS  PubMed  Google Scholar 

  9. Dinkel, H. P., Danuser, H. & Triller, J. Blunt renal trauma: minimally invasive management with microcatheter embolization experience in nine patients. Radiology 223, 723–730 (2002).

    Article  PubMed  Google Scholar 

  10. McBane, R. D. Jr & Wysokinski, W. E. Treatment of venous thrombosis at unusual sites. Curr. Treat. Options Cardiovasc. Med. 10, 136–145 (2008).

    Article  PubMed  Google Scholar 

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Author information

Author notes

  1. M. Singh Gulati, Department of Imaging, Queen Elizabeth Hospital, Stadium Road, Woolwich, London SE18 4QH, UK m_gulati@hotmail.com

Authors and Affiliations

  1. Department of Urology, Queen Elizabeth Hospital NHS Trust, London, UK

    Arun Sahai & Ramon Niekrash

  2. Department of Radiology, Queen Elizabeth Hospital NHS Trust, London, UK

    Faye Cuthbert & Manpreet Singh Gulati

  3. Department of General Surgery, Queen Elizabeth Hospital NHS Trust, London, UK

    Midhat Siddiqui

Authors
  1. Arun Sahai
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  2. Faye Cuthbert
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  3. Ramon Niekrash
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  4. Midhat Siddiqui
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  5. Manpreet Singh Gulati
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The authors declare no competing financial interests.

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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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  • DOI: https://doi.org/10.1038/nrurol.2009.79

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