Types 6 (Renal Trauma)

hage_7a_n.jpg: Catheter angiography in a 9-year-old girl with blunt abdominal trauma. The lower renal pole of the right side is detached from the residual kidney and displaced in a caudal direction; it has a decreased blood supply of the parenchyma. hage_7b_n.jpg: The same examination in a 2-year-old girl with a blunt renal trauma. Late-arterial stage: Interruption of the continuity of the left kidney in the middle of the kidney which has led to an insufficient arterial blood supply of the lower renal half. hage_7a_n.jpg and hage_7b_n.jpg: In both cases probably a grade 4 (IV) renal trauma is present with a deficient blood supply of the right upper pole and the left lower renal part. It is possible to imagine the site of bleeding, especially in figure hage_7b_n.jpg. A confirmation of a laceration of the renal pelvis is impossible without a late x-ray with pyelography. Indications for surgery are instability of the circulation in spite of replacement of blood volume, large laceration of the pelvis, and/or large devitalized renal parts. In case of a non-operative treatment early and late follow-ups are indicated in any case with x-ray. $$hage_37??££See picture for comparison.§§