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Titolo:
A conservative approach to major blunt renal lacerations with urinary extravasation and devitalized renal segments
Autore:
Moudouni, SM; Patard, JJ; Manunta, A; Guiraud, P; Guille, F; Lobel, B;
Indirizzi:
CHU Pontchaillou, Dept Urol, F-35033 Rennes, France CHU Pontchaillou Rennes France F-35033 Dept Urol, F-35033 Rennes, France
Titolo Testata:
BJU INTERNATIONAL
fascicolo: 4, volume: 87, anno: 2001,
pagine: 290 - 294
SICI:
1464-4096(200103)87:4<290:ACATMB>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
SURGICAL-MANAGEMENT; TRAUMA; INJURY; TERM;
Keywords:
kidney; trauma; blunt injury; management; outcome;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
21
Recensione:
Indirizzi per estratti:
Indirizzo: Moudouni, SM CHU Pontchaillou, Dept Urol, 2 Rue Henri le Guilloux, F-35033Rennes, France CHU Pontchaillou 2 Rue Henri le Guilloux Rennes France F-35033
Citazione:
S.M. Moudouni et al., "A conservative approach to major blunt renal lacerations with urinary extravasation and devitalized renal segments", BJU INT, 87(4), 2001, pp. 290-294

Abstract

Objectives To determine the feasibility of a conservative (expectant) approach to major blunt renal laceration with urinary extravasation and devitalized renal segments. Patients and methods All patients treated conservatively who presented between 1990 and 1999 with major renal laceration (grade 4 and 5) were retrospectively reviewed to determine whether urinary extravasation and devitalized segments adversely affected the outcome. For each patient the data collected included the initial emergency department evaluation, findings on computed tomography, associated injuries, duration of hospital stay, transfusionrequirements, complications and follow-up imaging. Results Of 20 patients who sustained blunt trauma resulting in a major renal laceration (five grade 5 and 15 grade 4) with urinary extravasation, 11 had coexisting devitalized segments. There was a statistically significant difference in the length of hospital stay (16.3 vs 7.3 days), blood transfusions (six vs two patients, P<0.08) and the need for delayed surgical intervention (nine vs two, P<0.01) between patients with and with no devitalizedsegments, respectively. Urinary extravasation spontaneously resolved in two of 11 patients with and in seven of nine with no devitalized segment, respectively (P<0.05)Conclusions Urinary extravasation will resolve spontaneously in most patients with blunt renal trauma, and expectant treatment does not adversely affect the outcome or prolong hospitalization. In patients who present with a major renal laceration associated with devascularized segments, conservative management is feasible in those who are clinically stable with blunt trauma. However, the physician must be especially aware of the probable complications within this subset of patients.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 24/01/20 alle ore 13:33:18