Renal Pedicle Injury in the Multiple Injured Patient

Abstract

Renal pedicle injuries were associated with multiple system trauma and a 42% mortality rate in 31 patients seen from 1959-1978. These injuries were to the renal artery in 14 patients, branches of the renal artery in 5, the renal vein in 8, and the renal artery and vein in 4. Priority of treatment for life-threatening associated injuries resulted in delayed diagnosis of the renal pedicle injury which was not optimal for preservation of functioning renal tissues. Since 1968 an immediate excretory urogram was performed for hematuria or a perirenal hematoma found during laparotomy for associated injuries. This study has resulted in the early diagnosis of renal pedicle injuries and immediate vascular repair was attempted in 6 patients. Three of these patients survived with no hypertension on follow up. A repaired renal vein in 1 patient resulted in normal renal function and renal arteries were repaired in the other 2 patients with reduced renal function.