injuries poisoning
Renal Trauma
Introduction
The kidney is injured in up to 10% of patients who sustain significant abdominal trauma. Overall about 65% of genitourinary (GU) injuries involve the kidney. It is the most commonly injured GU organ from civilian external trauma. Most renal injuries (85 to 90% of cases) result from blunt trauma, typically due to motor vehicle crashes, falls, or assaults, and are low grade. The most common accompanying injuries are to the head, central nervous system, chest, spleen, and liver. Penetrating injuries usually result from gunshot wounds and are usually associated with multiple injuries, including to the chest, liver, intestine, and spleen. Renal injuries are classified according to severity into 5 grades: Grade 1: Subcapsular hematoma and/or renal contusion Grade 2: Laceration≤1 cm in depth without urinary extravasation Grade 3: Laceration> 1cm without urinary extravasation Grade 4: Laceration involving the collecting system with urinary extravasation; any segmental renal vascular injury; renal infarction; renal pelvis laceration and/or ureteropelvic disruption Grade 5: Shattered or devascularized kidney with active bleeding; main renal vascular laceration or avulsion 