الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
In the present thesis different aspects of the diagnostics and treatment of patients with renal injury are reported. Currently, the role of
the CT scanner is very important, because of its high sensitivity (90 –
100%) to detect injuries to the kidney and associated (intra-abdominal) injuries. Furthermore, the presence and exact localisation of contrast extravasation can be detected. Advances in CT technology have improved the physician’s ability to determine more details of the parenchymateous injury and minor vascular lesions. Since vascular injuries are associated with failure of NOM, improvements in CT technology seem advantageous for the patient selection for the best treatment and thus to prevent failure of
NOM. Multislice computed tomography (MSCT) is the imaging modality of choice in assessing clinically stable patients with renal trauma. This study
assessed the role of MSCT in the detection of renal injury caused by blunt and open trauma in our centre and its impact on treatment options , within a two-year-period (2011-2013). A total of 50 patients, 40 males and 10
females had MSCT abdomen for abdominal trauma 40 cases of blunt trauma and 10 cases of open trauma , with high suspicion of renal injury within this study period. Positive scan for renal injury were seen in all patients (100%). More than half of the cases, 30 cases had minor renal lesions and the remaining 20 cases had major lesions Out of these positive scans as regard other visceral injuries, liver , spleen ,pancreas, bone and bowel injuries were seen in 46% (n=23) , 30% (n=15) ,6%(n=3), 10%(n=5), and 20%(n=10) of cases respectively. Conservative ; non operative
management (NOM) was performed in 32 patients (64%) and laparotomies were performed in the remaining 18 patients. Out of these 18 laparotomies, 10 patients had surgically significant injuries that were missed on CT scan
findings. The injuries were bowel perforation (n=4), serosal tear of bowel
(n=1), mesenteric injuries with active haemorrhage (n=3), spleen injury
(n=1) and liver injury (n=1). On exploration, total nephrectomy was
performed in 7 cases, renal repair was performed in 8 cases and partial
nephrectomy was done in 3 cases. The outcome of conservative treatment
was uneventful recovery with nearly no complications. But for surgical
interference cases. There were 2 cases of secondary haemorage one after partial nephrectomy and the other one following renal repair, and 2 cases of
urinoma and hydronephrosis following repair, one complicated by abscess
formation, in both of them ureteric stent was performed and managed with
antibiotics and analgesics.