Conservative management of a grade 4 renal laceration in a child

Abstract

Renal trauma associated with blunt abdominal trauma is common. Children presenting with grade 4 or 5 renal lacerations who are hemodynamically stable can be followed safely nonoperatively. No long-term complications from conservative management have been noted.

Figure 1

The initial CT scan from the emergency department. A large left perirenal hematoma is noted with questionable extravasation of contrast material.

Figure 2

A CT scan performed 2 months after the accident shows resolution of the perirenal hematoma. Areas of nonfunctioning parenchyma remain.

Figure 3

A CT scan performed 4 months after the accident shows a relatively normal-appearing kidney with good function.