id	author	title	date	pages	extension	mime	words	sentence	flesch	summary	cache	txt
ecj-11577	Pothiawala, Sohil; Schroll, Rebecca	Renal trauma during a rugby tackle	2023	3	.pdf	application/pdf	2198	122	50	The indications for radiologic evaluation of renal injury in blunt trauma include: i) clinical signs suggestive of renal trauma e.g., abdominal tenderness, distension, flank pain, ipsilateral lower rib fractures; ii) gross hematuria; iii) microscopic hematuria and one episode of hypotension (pre-hospital or initial ED systolic BP <90mm Hg); iv) presence of other major injuries Hemodynamically stable patients with microscopic hematuria, those with low-grade renal injuries (I-III), and even those with high-grade renal injuries (IV-V) can be managed conservatively. Angiography and selective embolization have shown a high success rate in the management of patients with high-grade (Grade IV and V) renal injuries with ongoing bleeding or vascular compli- cations.3,10 Patients with significant extravasation of urine on CT scan should be treated with retrograde ureteral stents to prevent development of a urinoma.2 Surgical intervention is required in less than 5% of patients, especially for hemodynamically unstable patients, or those with complete avulsion of the ureteropelvic junc- tion, or an expanding/pulsatile retroperitoneal hematoma sugges- tive of renal pedicle injury, to control hemorrhage and salvage the kidney.1 3-10% of patients with renal trauma develop complications like urinoma, delayed bleeding, hypertension, hydronephrosis, pyelonephritis, perinephric abscess, arteriovenous fistula, urinary fistula, and pseudoaneurysm.11 As the risk of complications is higher in patients with high-grade injuries, these patients should be discharged with appropriate follow-up with trauma/general surgery and/or urologist.	cache/ecj-11577.pdf	txt/ecj-11577.txt