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Salvation of a solitary kidney in a patient with grade IV renal trauma: a case report
Hyuntack Shin, Ae Jin Sung, Min A Lee, Jayun Cho, Gil Jae Lee, Byungchul Yu, Kang Kook Choi
J Trauma Inj. 2022;35(Suppl 1):S18-S22.   Published online June 17, 2022
DOI: https://doi.org/10.20408/jti.2021.0091
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AbstractAbstract PDF
There are many reasons for solitary kidney. Congenital causes include renal agenesis and dysplasia. Acquired causes include nephrectomy performed for reasons including traumatic kidney injury, disease (e.g., renal cell carcinoma), and donation for kidney transplantation. According to the European Association of Urology, the World Society of Emergency Surgery, and the American Association for the Surgery of Trauma guidelines, it is important to preserve the remaining renal function as much as possible when a solitary kidney patient has suffered a traumatic kidney injury. The authors present a case of kidney preservation in a solitary kidney patient with a traumatic grade IV renal injury through non-operative management involving superselective renal artery angioembolization.
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Non-Permanent Transcatheter Proximal Renal Artery Embolization for a Grade 5 Renal Injury with Delayed Recanalization and Preserved Renal Parenchymal Enhancement
Abhishek Jairam, Bradley King, Zachary Berman, Gerant Rivera-Sanfeliz
J Trauma Inj. 2021;34(3):198-202.   Published online September 30, 2021
DOI: https://doi.org/10.20408/jti.2020.0075
  • 3,596 View
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  • 2 Citations
AbstractAbstract PDF

Super-selective renal artery embolization is an increasingly popular technique for the management of traumatic, low-grade renal trauma. When performed in distal arterial branches, this intervention enables tissue preservation and arrest of hemorrhage, but it may not be practical in cases of multifocal, high-grade renal injuries. In such cases, surgical nephrectomy remains the more common treatment modality to ensure hemodynamic control. We present the unique case of a patient who presented in hemorrhagic shock following a major trauma that resulted in a grade 5 renal injury treated with complete renal artery embolization using Gelfoam, resulting in hemodynamic stabilization. Interestingly, imaging 1 month after embolization revealed residual enhancement of the inferior pole of the kidney, suggesting reconstitution of flow and partial renal salvage. Ultimately, transcatheter “nephrectomy” with careful selection of a temporary embolic agent may serve as a safe and efficient alternative to surgical nephrectomy with the added possibility of preserving partial renal perfusion and function in the emergent setting.

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  • Salvation of a solitary kidney in a patient with grade IV renal trauma: a case report
    Hyuntack Shin, Ae Jin Sung, Min A Lee, Jayun Cho, Gil Jae Lee, Byungchul Yu, Kang Kook Choi
    Journal of Trauma and Injury.2022; 35(Suppl 1): S18.     CrossRef
  • The Role of Renal Artery Embolisation in the Management of Blunt Renal Injuries: A Review
    Rosemary Denning Ho, Vivek Shrivastava, Amir Mokhtari, Raghuram Lakshminarayan
    Vascular and Endovascular Review.2022;[Epub]     CrossRef

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