Renal injury: AAST grade IV

Case contributed by Dr Aliakbar Sahraei


Multiple traumatic injuries.

Patient Data

Age: 30 years
Gender: Male

Grade IV renal injury

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 haematoma surrounds the kidney and the ureter.


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 haemorrhage
  • segmental infarctions without associated lacerations
  • expanding subcapsular haematomas compressing the kidney
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Case information

rID: 48317
Case created: 30th Sep 2016
Last edited: 12th Dec 2017
Systems: Urogenital, Trauma
Inclusion in quiz mode: Included

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