Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

03 August 2021: Articles

Role of Emergent Nephrectomy for Grade V Blunt Renal Injuries

Unusual clinical course, Challenging differential diagnosis, Management of emergency care

John D. Ehrhardt A , Adel Elkbuli A* , Mark McKenney A , Dessy Boneva A

DOI: 10.12659/AJCR.932357

Am J Case Rep 2021; 22:e932357

Table 1. AAST Revised 2018 Renal Injury Grading Scale [2].

DescriptionGeneral management
ISubcapsular hematoma/renal parenchymal contusion without lacerationObservation, no restrictions in absence of other injuries
IIHematoma confined to Gerota’s fascia; lacerationObservation, bedrest, hemoglobin/hematocrit trending
IIILaceration >1 cm with no collecting duct injury; any urinary or vascular extravasationResuscitation, angioembolization, H&H trending, hemodynamic monitoring
IVLaceration of collecting system; ureteropelvic transection; hemorrhage beyond Gerota’s fascia; segmental vessel bleeding/thrombosisResuscitation, angioembolization vs operative management; above measures; likely repeat CT imaging
VShattered kidney with destroyed parenchyma; main renal vessel avulsion; devascularized kidney with active bleedingSimilar to grade IV management, controversial and based on patient stability and response to resuscitation
AAST– American Association for the Surgery of Trauma; CT – computed tomography; H&H – hematocrit and hemoglobin.
* Current evidence on follow-up imaging is evolving literature.

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923