Alexander Salcedo, Carlos A Ordoñez, Michael W Parra, José Daniel Osorio, Philip Leib, Yaset Caicedo, Mónica Guzmán-Rodríguez, Natalia Padilla, Luis Fernando Pino, Mario Alain Herrera, Adolfo González Hadad, José Julián Serna, Alberto García, Federico Coccolini, Fausto Catena
{"title":"Damage Control for renal trauma: the more conservative the surgeon, better for the kidney.","authors":"Alexander Salcedo, Carlos A Ordoñez, Michael W Parra, José Daniel Osorio, Philip Leib, Yaset Caicedo, Mónica Guzmán-Rodríguez, Natalia Padilla, Luis Fernando Pino, Mario Alain Herrera, Adolfo González Hadad, José Julián Serna, Alberto García, Federico Coccolini, Fausto Catena","doi":"10.25100/cm.v52i2.4682","DOIUrl":null,"url":null,"abstract":"<p><p>Urologic trauma is frequently reported in patients with penetrating trauma. Currently, the computerized tomography and vascular approach through angiography/embolization are the standard approaches for renal trauma. However, the management of renal or urinary tract trauma in a patient with hemodynamic instability and criteria for emergency laparotomy, is a topic of discussion. This article presents the consensus of the Trauma and Emergency Surgery Group (CTE) from Cali, for the management of penetrating renal and urinary tract trauma through damage control surgery. Intrasurgical perirenal hematoma characteristics, such as if it is expanding or actively bleeding, can be reference for deciding whether a conservative approach with subsequent radiological studies is possible. However, if there is evidence of severe kidney trauma, surgical exploration is mandatory and entails a high probability of requiring a nephrectomy. Urinary tract damage control should be conservative and deferred, because this type of trauma does not represent a risk in acute trauma management.</p>","PeriodicalId":50667,"journal":{"name":"Colombia Medica","volume":null,"pages":null},"PeriodicalIF":0.7000,"publicationDate":"2021-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b6/62/1657-9534-cm-52-02-e4094682.PMC8216050.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Colombia Medica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.25100/cm.v52i2.4682","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Urologic trauma is frequently reported in patients with penetrating trauma. Currently, the computerized tomography and vascular approach through angiography/embolization are the standard approaches for renal trauma. However, the management of renal or urinary tract trauma in a patient with hemodynamic instability and criteria for emergency laparotomy, is a topic of discussion. This article presents the consensus of the Trauma and Emergency Surgery Group (CTE) from Cali, for the management of penetrating renal and urinary tract trauma through damage control surgery. Intrasurgical perirenal hematoma characteristics, such as if it is expanding or actively bleeding, can be reference for deciding whether a conservative approach with subsequent radiological studies is possible. However, if there is evidence of severe kidney trauma, surgical exploration is mandatory and entails a high probability of requiring a nephrectomy. Urinary tract damage control should be conservative and deferred, because this type of trauma does not represent a risk in acute trauma management.
期刊介绍:
Colombia Médica is an international peer-reviewed medical journal that will consider any original contribution that advances or illuminates medical science or practice, or that educates to the journal''s’ readers.The journal is owned by a non-profit organization, Universidad del Valle, and serves the scientific community strictly following the International Committee of Medical Journal Editors (ICMJE) and the World Association of Medical Editors (WAME) recommendations of policies on publication ethics policies for medical journals.
Colombia Médica publishes original research articles, viewpoints and reviews in all areas of medical science and clinical practice. However, Colombia Médica gives the highest priority to papers on general and internal medicine, public health and primary health care.