CASE REPORT
Year : 2020  |  Volume : 32  |  Issue : 4  |  Page : 167-169

Conservative management of hemodynamically stable patient with grade V renal trauma: Case presentation and review of the literature


Department of Urology, General Hospital of Athens G.N.A. “G. Gennimatas,” Athens, Greece

Correspondence Address:
Charalampos Fragkoulis
Thessalias 24b Street, Kato Halandri, Athens
Greece
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/HUAJ.HUAJ_26_21

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Renal trauma is a major health problem involving mostly young patients. It is estimated that renal trauma is diagnosed in almost 5% of all trauma patients. Patients diagnosed with Grade V renal trauma require surgical intervention and usually nephrectomy. The aim of this study is to present a case of Grade V renal trauma in a hemodynamically stable patient treated conservatively in our department. A 24-year-old male was admitted to the urology department due to Grade V left renal trauma after a motor accident. The patient presented with hematuria and was hemodynamically stable. A conservative approach was performed with close monitoring of hemodynamic status. Two red blood cells units was transfused. The patient remained hemodynamically stable and renal hematoma reduced in size in follow-up computed tomography. The patient was discharged in excellent clinical status after 17 days of hospitalization. Although Grade V renal trauma involving vascular injury requires immediate surgical intervention, in selected patients diagnosed with shattered kidney, a conservative approach may be successful provided that the patient remains hemodynamically stable and under close monitoring. Hemodynamic instability is an absolute indication for surgical exploration and possible nephrectomy.


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