الفهرس 
Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
The kidney is the most commonly injured genitourinary and abdominal organ. Renal trauma occurs in approximately 1-5% of all trauma cases. Renal trauma is classified according to its mechanism to blunt, penetrating or iatrogenic injuries. The majority of cases are blunt traumas. With the proper evaluation of information which obtained clinically, radiographically, or surgically, renal injuries can be staged adequately. In the clinically stable patients, contrast enhanced CT scans with delayed images provides adequate data regarding the extent and severity of renal injury, while in hemodynamically unstable patients, operative staging may be necessary and findings from the one-shot intraoperative IVP may be useful. Nonoperative management has the upper hand in most cases of blunt renal injuries and may be used selectively in patients who present with penetrating injuries or even with shattered kidney with low rates of secondary complications, surgery, or renal loss. The absolute indications for surgical exploration in renal trauma are persistent, life-threatening hemorrhage. The need for renal exploration is usually influenced by the decision to explore or observe associated abdominal injuries. Angiography with selective renal embolisation for control of bleeding is an acceptable alternative to laparotomy provided that no other indication for immediate surgery exists. Follow-up examinations should continue until healing is documented and laboratory findings have stabilized, although checking for latent renovascular hypertension may need to continue for years. The rate of complications after renal trauma ranges from 3% and 33% of all patients. Early complications occur within the first month after injury and can be bleeding, infection, perinephric abscess, sepsis, urinary fistula, hypertension, urinary extravasation and urinoma. Delayed complications include bleeding, chronic pyelonephritis, hypertension, arteriovenous fistula and pseudoaneurysms. Most pediatric renal trauma is minor and carries no significant danger to the child. Selective management of pediatric renal trauma based on mechanism of injury, hemodynamic stability, associated nonrenal injuries, and CT imaging has led to a renal exploration rate of 5% to 11% with renal salvage rates of more than 98%.