Selective nonoperative management of kidney gunshot injuries.

World Journal of Surgery
P H Navsaria, Andrew J Nicol

Abstract

Nonoperative management (NOM) of kidney gunshot injuries as an alternative to surgical exploration is rarely reported. The aim of this study was to assess the feasibility and safety of selective NOM of such injuries. A 4-year prospective study was conducted that included all patients admitted to a Level I trauma center with kidney gunshot injuries. Patients with abdominal gunshot wounds and hematuria with no indications for immediate laparotomy (peritonitis, hemodynamic instability, head or spinal cord injury) underwent intravenous contrast abdominal computed tomography. Patients with confirmed kidney injuries were observed with serial clinical examinations. Outcome parameters included the need for delayed laparotomy, complications, length of hospital stay, and survival. During the study period, 33 patients with kidney gunshot injuries were selected for NOM without laparotomy. The mean Injury Severity Score was 10.5 (range 4-25). Simple kidney injuries (grades I, II) occurred in 15 (45.5%) patients and complex kidney injuries (grades III, IV) in 18 (54.5%) patients. Associated injuries included 14 of the liver (42.4%), 4 (12.1%) of the spleen, and 6 (18.2%) each of the diaphragm, lung (contusion), and hemothorax. Three patients...Continue Reading

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Citations

Sep 11, 2009·The Journal of Trauma·Narong Kulvatunyou
Sep 21, 2010·Current Opinion in Critical Care·Walter L Biffl, Ernest E Moore
Feb 13, 2016·American Journal of Surgery·Jack RostasRichard P Gonzalez
May 18, 2012·The Journal of Urology·C MoolmanA J Nicol
Oct 5, 2010·American Journal of Surgery·Pradeep H NavsariaAndrew J Nicol
Oct 16, 2014·World Journal of Surgery·Walter L Biffl, Ari Leppaniemi
Apr 25, 2016·Abdominal Radiology·Suzanne T ChongAnia Z Kielar
Jul 16, 2014·International Emergency Nursing·Nertisha Singh, Timothy C Hardcastle
Jan 28, 2016·Revista do Colégio Brasileiro de Cirurgiões·Bianca Luiza Valduga GuareschiLuiz Carlos Von Bahten
Mar 25, 2014·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Guoming ZhangNa Sun
Nov 1, 2013·Revista do Colégio Brasileiro de Cirurgiões·Bruna Pozzi CesarDomingos André Fernandes Drumond
Jan 26, 2018·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Pradeep NavsariaSharfuddin Chowdhury
Sep 1, 2012·Revista do Colégio Brasileiro de Cirurgiões·Sizenando Vieira StarlingDomingos André Fernandes Drumond
Dec 5, 2018·World Journal of Emergency Surgery : WJES·Aziza N Al RawahiDerek J Roberts
Aug 31, 2021·Injury·Willem Estienne du PlessisDamian Luiz Clarke

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