Renal Trauma: When to Embolize?
Purpose of Review
The management of solid organ injury continues to evolve from operative therapy to non-operative therapy with the highest success rates seen in the management of blunt renal trauma. Angio-embolization has emerged as an important modality to increase the success rate of non-operative management of kidney injuries.
There is a paucity of literature defining the optimal indications for renal embolization, but several retrospective reviews indicate the computed tomography findings associated with the need for renal embolization. Pseudoaneurysms, large perirenal hematomas with associated intravenous contrast extravasation, and arteriovenous fistulas strongly indicate the need for embolization, while discontinuity of Gerota’s fascia, moderate hematomas, and medially located renal lacerations partially suggest that embolization will be required.
The successful management of renal trauma is not solely dependent on the use of renal artery embolization.
KeywordsKidney laceration Perirenal hematoma Contrast extravasation Embolization Perirenal hematoma rim distance Gerota’s fascia
Compliance with Ethical Guidelines
Conflict of Interest
Dr. Adams declares no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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