Grade V Renal Injury - Short and Long Term Outcome

• Main Authors: Rajendra B Nerli (Author), Vikas Sharma (Author), Basavaraj M Kajagar (Author), Neeraj S Dixit (Author), Nitin D Pingale (Author)
• Format: Book
• Published: Open Journal of Trauma - Peertechz Publications, 2017-03-13.
• Subjects: Research Article
• Online Access: Connect to this object online.

<p><strong>Introduction: </strong>Over the last few decades, non- operative management (NOM) has become increasingly popular, especially for low-grade (I-III) blunt renal injuries.The published evidence is unclear about the role of NOM for higher grades (IV and V). We took up this study to report our short and long-term outcomes following initial nonoperative management in patients sustaining a grade 5 renal injury secondary to blunt trauma.</p><p><strong>Materials and Methods:</strong> The charts of all patients who presented to our institution with blunt renal trauma between Jan 2000 and Dec 2014 and had grade V renal injury were identifed and analyzed.</p><p><strong>Results:</strong> 114 patients were identified, with grade V renal injury following blunt trauma (BRI). 9/114 patients (7.89%) died following resuscitation in the casualty and emergency services, 4 (3.50%) of whom had deaths that were related to the kidney injury. 36 (34.28%) underwent early surgical exploration (13 - 42 hours) for various indications and nephrectomy was performed in 21 (58.33%). Eight patients who were on non-operative management needed delayed surgical exploration of which two patients (25%) presenting with massive secondary bleeding needed nephrectomy for control of the bleeding.</p><p><strong>Conclusions:</strong> 41.9% of patients with grade V renal injury needed surgical exploration of which 34.28% underwent early, whereas 7.61% underwent delayed exploration. 58.33% of patients undergoing early exploration and 25% of patients undergoing delayed exploration ended up with nephrectomy. Non operative management would be safe in the majority of patients with grade V renal injuries secondary to blunt trauma.</p>