Renal injuries – treatment
Tomasz Ząbkowski1, Ryszard Skiba1, Agnieszka Grabińska1, Artur Maliborski2, Tomasz Syryło1, Henryk Zieliński1
The anatomical structure of urogenital system contributes to high risk of mechanical injuries. The group which is particularly exposed to renal injuries are young men doing sports, the injured of road accidents, victims of accidents in the house or at work. The authors present the medical and surgical treatment after renal injuries. There are blunt and penetrating renal injuries as well as a 5-level classification of kidney injuries according to a degree of injuries – AAST. This classification enables to perform a standardization of different patient groups to choose a proper therapy and to predict the results of treatment. The most of renal injuries involves the medical treatment. However, it is often needed the surgical intervention. The indications for surgical treatment are haemodynamic instability, necessity of surgical verification of concomitant injuries, expanding or throbbing perirenal haematoma confirmed in laparotomy, grade 5 injury. The patients with the serious renal injury should undertake necessary medical examinations to determine a range of injury and to undertake the appropriate treatment. Furthermore, the longterm medical controls are recommended. The contemporary treatment’s approaches, especially AAST scale, are going to medical treatment of blunt renal injuries. The injuries of 1–3 grade are usually treated conservatively and in case of grade 4 and 5, a surgical procedure is needed. Conservative treatment of grade 1–3 injuries does not relate to a risk of late complications. The renal-vascular injuries of 5 grade are treated as an absolute indication for exploratory surgery.