The diagnosis and management of blunt renal injuries

Blunt renal trauma includes a range of lesions from minor, low-energy contusions with almost no clinical significance to high-energy injuries in which the kidney may be totally disrupted. Classification of these injuries is important because, although most patients can safely be managed conservatively, intervention may sometimes be necessary. As clinical assessment is inaccurate, urine examination and radiology have been relied upon to classify such lesions. There has been prolonged debate concerning optimal guidelines for and methods of radiological assessment, as well as regarding the indications for surgery. In this review we will discuss recent work on the diagnosis and treatment of blunt renal injuries, with a summary of previous studies, and suggest guidelines for the management of such patients.