Manejo conservador en trauma renal contuso. Algunas recomendaciones para recordar

Palabras clave: Trauma, renal, contuso, manejo, conservador

Resumen

Descripción resumida del tema: El manejo en trauma renal contuso se basa en la vigilancia clínica y paraclínica durante las primeras 24 horas. La imagen de elección es la tomografía axial computarizada (TAC) de 3 fases. Se debe tomar en todo paciente con sospecha clínica de trauma renal y repetir sólo en caso de deterioro clínico. En pacientes con factores de riesgo para trombosis, se debe utilizar profilaxis o medias de compresión neumática en caso de contraindicación al uso de heparinas.  No se ha llegado a consenso definitivo sobre el uso de antibioticoterapia, sin embargo, se recomienda en pacientes con signos de infección aguda.

Relevancia: El trauma renal es una enfermedad con una prevalencia importante a nivel mundial y en nuestro medio, presente en el 5% de los pacientes de trauma. Dadas las recomendaciones basadas en evidencia escasa, se prefiere el manejo conservador, incluso en pacientes con traumas de alto grado.

Conclusiones: Se recomienda el manejo conservador del trauma renal contuso grado I-IV. Aún existe controversia sobre el trauma renal grado V. Se sugiere evitar la profilaxis antibiótica dada la baja tasa de infección y se indica el uso de antibiótico en presencia de signos clínicos de infección.

Citas

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Publicado
2020-10-28
Sección
Artículos de revisión