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Renal Trauma: When to Embolize?

  • Charles A. AdamsJr.Email author
Trauma Surgery (J. Diaz, Section Editor)
Part of the following topical collections:
  1. Trauma Surgery

Abstract

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.

Recent Findings

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.

Summary

The successful management of renal trauma is not solely dependent on the use of renal artery embolization.

Keywords

Kidney laceration Perirenal hematoma Contrast extravasation Embolization Perirenal hematoma rim distance Gerota’s fascia 

Notes

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.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science + Business Media New York 2016

Authors and Affiliations

  1. 1.Division of Trauma and Surgical Critical CareRhode Island HospitalProvidenceUSA
  2. 2.Department of SurgeryWarren Alpert Medical School of Brown UniversityProvidenceUSA

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