injuries poisoning
Renal Trauma
Treatment of Renal Trauma
Strict bed rest and, for patients admitted to the hospital, close monitoring of vital signs Surgical repair or angiographic intervention for some blunt and most penetrating high-grade renal injuries Most blunt renal injuries, including all grade 1 and 2 and most grade 3 and 4 injuries, can be safely managed nonoperatively; most patients with grades 1 or 2 and some with grade 3 can be discharged. Patients should be maintained on strict bed rest until the gross hematuria has resolved. Prompt intervention is required for patients with the following: Persistent bleeding (ie, enough to necessitate repeated Technique of Transfusion ) Expanding perinephric hematoma Renal pedicle avulsion or other significant renovascular injuries Ureteropelvic junction disruption Intervention can include surgery, stent placement, or selective angiographic embolization. Penetrating trauma usually requires surgical exploration, although observation may be appropriate for patients in whom the renal injury has been accurately staged by CT, blood pressure is stable, and no associated intra-abdominal injuries require surgery. 