Vascular ischemic lesions of the kidney in multiple trauma patients: Incidence and management, a report of 7 cases Lésions vasculaires ischémiques rénales chez le polytraumatisé: Incidence et prise en charge à propos de 7 cas

摘要

Vascular ischemic lesions of the kidney in multiple trauma patients: incidence and management, a report of 7 cases. Aims. Study the incidence, type and outcome of traumatic ischemic arterial lesions of the kidney in multiple trauma patients.Materials and methods. Retrospective study of 500 multiple trauma patients who underwent whole body 64 slice CT Scan (mean age 34 years old, sex ratio 4M/1W, mean ISS 29).Results. There were seven cases of vascular lesions of the left kidney 1.4 of patients (men, median age 25 years old, mean ISS43.9). These were closed traumas with sudden deceleration and dissection of the renal artery trunk in three cases and injury to its branches in four cases with preserved excretion. Three patients died of associated injuries, including one patient who received a stent on D0. One patient underwent a nephrectomy and the three other patients were not treated which did not affect renal function or pressure (follow-up 19 months).Conclusion. We found a high incidence of traumatic renal dissection in multiple trauma patients. Multidetector scan appears to provide the best results for the diagnosis of these lesions as well as the many associated lesions resulting in a very poor prognosis for these patients. Treatment is not well defined and management of these lesions is often of secondary importance because of the severity of associated injuries.