External Validation of a Substratification of the American Association for the Surgery of Trauma Renal Injury Scale for Grade 4 Injuries

Grade IV renal trauma management. A revision of the AAST renal injury grading scale is mandatory

“…Figler et al [28] also have validated these risk factors: among patients with blunt grade IV renal injury, the presence of ≥2 high-risk criteria (perirenal hematoma size, intravascular contrast extravasation, and medial or complex laceration) effectively predicts the need for intervention for hemodynamic instability, and can be used to identify patients who require intensive monitoring.…”

Retroperitoneal Laparoscopic Nephrectomy for Acute Blunt Grade 4 Renal Injuries

“…There are some risks associated with nonoperative treatment, including delayed renal bleeding, delayed nephrectomy, urine leakage, urinoma, persistent fever, venous thromboembolism after prolonged immobilization, renal insufficiency, arteriovenous fistula, aneurysm, and even death. 8,9 Patients with renal injuries rated Grade 4 or higher have increased morbidity and mortality rates for conservative treatment. The incidence of functional renal loss and death occurred in 16% and 7% of patients with Grade 4 renal injuries, respectively.…”

“…The incidence of functional renal loss and death occurred in 16% and 7% of patients with Grade 4 renal injuries, respectively. 8,9 About 29% of Grade 4 and 60% of Grade 5 renal injuries required surgical intervention. 8 About 10% of Grade 4 injuries required nephrectomy.…”

“…8,9 About 29% of Grade 4 and 60% of Grade 5 renal injuries required surgical intervention. 8 About 10% of Grade 4 injuries required nephrectomy. 2 Highrisk factors requiring intervention for patients with Grade 4 injuries include a perirenal hematoma rim distance of >3.5 cm, expanding renal mass, renal pelvis injury, intravascular contrast extravasation, and AAST Grade 4 hilar injury.…”

Blunt abdominal trauma. Kidneys injury. Part 3

“…рецидива кровотечения. К ним относят одновременное повреждение нескольких парен-химатозных органов живота [18], экстравазацию контрастного вещества при КТ, паранефральную гематому размером более 3,5 см и сочетание этих факторов с разрывом медиальной поверхности поч-ки [33,42], возраст старше 55 лет и дорожно-транс-портное происшествие как механизм травмы [105], травму почки V степени и необходимость в перели-вании тромбоцитной массы [70], нарушение цело-сти фасции Герота и увеличение паранефрального кровоизлияния [35]. J. Charbit и соавт.…”