Conservative management in blunt renal trauma. Some tips to remember

Abstract

Summary description of the topic: Management in blunt renal trauma is based on clinical and paraclinical surveillance during the first 24 hours. The image of choice is 3-phase computed tomography (CT). It should be taken in all patients with clinical suspicion of renal trauma and repeat only in case of clinical deterioration. In patients with risk factors for thrombosis, prophylaxis should be used or pneumatic compression socks in case of contraindication to the use of heparins. No definitive consensus has been reached on the use of antibiotic therapy, however, it is recommended in patients with signs of acute infection.

Relevance: Renal trauma is a disease with an important prevalence worldwide and in our environment, present in 5% of trauma patients. Given the recommendations based on scant evidence, conservative management is preferred, even in patients with high-grade trauma.

Conclusions: Conservative management of grade I-IV blunt renal trauma is recommended. There is still controversy about grade V renal trauma. Antibiotic prophylaxis is avoided given the low rate of infection and antibiotic use is indicated in the presence of clinical signs of infection.