Presentation
Multiple traumatic injuries.
Patient Data
Age: 30 years
Gender: Male
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Right renal laceration extends to renal pelvis is seen.
There is a small contrast blush at the mid pole posteromedially raising the possibility of active bleeding.
Large perinephric hematoma surrounds the kidney and the ureter.
Conclusion:
Right renal laceration (AAST Grade IV injury) as described above with active bleeding, and evidence of extravasation from the collecting system.
Case Discussion
The AAST (American Association for the Surgery of Trauma) renal injury scale is the most widely used renal trauma grading system. Severity is assessed according to the depth of renal parenchymal damage and involvement of the urinary collecting system and renal vessels.
Grade IV
- laceration extends to renal pelvis or urinary extravasation
- vascular: injury to main renal artery or vein with contained hemorrhage
- segmental infarctions without associated lacerations
- expanding subcapsular hematomas compressing the kidney
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