TABLE 2545 Indications for Operative Exploration or Intervention in Renal Injury3

Renal pedicle injuries are usually associated with multiple life-threatening injuries, and the safest surgical option is nephrectomy. In a stable patient with an isolated renal pedicle injury, repair should be undertaken within 12 h of the injury if a viable kidney is to result. Thrombosis of segmental arteries is treated conservatively.

Surgical exploration consists of preliminary vascular control, debridement, and surgical repair. Early control of the renal vessels decreases the nephrectomy rate in potentially salvageable kidneys. Nephrectomy, however, may be necessary in unstable patients.

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