Increasing role of angiography and segmental artery embolization in the management of renal stab wounds
Date
1992
Authors
Heyns C.F.
Van Vollenhoven P.
Journal Title
Journal ISSN
Volume Title
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Abstract
During a 5-year period 93 patients with stab wounds involving the upper urinary tract were treated. Of these patients 79 were treated initially at our department (group 1) and 14 were referred with complications after initial treatment elsewhere (group 2). In group 1, 26 patients (33%) were selected for surgery on the basis of signs of severe blood loss or associated intra-abdominal injury, or major abnormality on the excretory urogram. At operation a major renal injury and/or associated intra-abdominal laceration was found in 23 patients (88%) and nephrectomy was required in 7 (27%) of them. Nonoperative management was selected in 53 patients (67%) in group 1 and secondary hemorrhage occurred in 8 (15%). Of the patients in group 2, 4 had undergone an operation elsewhere and 10 had been managed nonoperatively. Renal arteriography was performed in 14 patients who had been managed nonoperatively (6 from group 1 and 8 from group 2) and demonstrated a traumatic pseudoaneurysm in 6, an arteriovenous fistula in 5 and no large vessel injury in 3. Selective embolization of the involved segmental artery was successful in 9 of 11 patients (82%) when angiography showed a vascular lesion. This study demonstrates the increasingly important role of renal angiography and selective embolization in the selective nonoperative management of patients with stab wounds of the kidney.
Description
Keywords
abdominal injury, adolescent, adult, arteriovenous fistula, article, artificial embolism, bleeding, false aneurysm, female, hematuria, human, intravenous urography, kidney angiography, kidney arteriography, kidney injury, major clinical study, male, nephrectomy, postoperative complication, priority journal, stab wound, vascular lesion, Adolescent, Adult, Embolization, Therapeutic, Female, Human, Kidney, Male, Middle Age, Renal Artery, Retrospective Studies, Wounds, Stab
Citation
Journal of Urology
147
5
147
5