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TheScientificWorldJOURNAL
Volume 6 (2006), Pages 2334-2338
http://dx.doi.org/10.1100/tsw.2006.364
Case Study

Blunt Renal Trauma in a Pre-Existing Renal Lesion

Department of Urology, Assir Central Hospital, ABHA, Saudi Arabia

Received 10 January 2006; Accepted 23 January 2006

Academic Editor: Ziya Kirkali

Copyright © 2006 G.V. Soundra Pandyan et al.

Abstract

A 70-year-old male presented with direct trauma to his loin with gross hematuria, as an isolated case of blunt renal trauma (BRT) due to a traffic accident. A pre-existing renal lesion (PERL) was strongly suspected by his past history of gross macroscopic hematuria and monotrauma to the kidney without other associated injuries. Spiral CT scan with contrast and a retrograde pyelogram (RGP) confirmed an occult complex renal cyst. The gold standard of CT diagnosis in this situation is stressed. Computed tomography is particularly useful in evaluating traumatic injuries to kidneys with pre-existing abnormalities. The decision on the initial course of conservative management, ureteral retrograde stenting to drain extravasation, and its final outcome are discussed. Radical nephroureterectomy was carried out by a transperitoneal approach with an early vascular control of the renal pedicle. A brief review of recent literature has been undertaken.