Selective management of renal gunshot wounds

G. C. Velmahos, D. Demetriades, E. E. Cornwell, H. Belzberg, J. Murray, Juan A. Asensio, T. V. Berne

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

Background: Gunshot wounds to the kidney have been managed traditionally by surgical exploration. Concerns over increased nephrectomy rates and unnecessary explorations have placed this method under scrutiny. Selective renal exploration based on solid clinical and radiographic criteria may be a safer alternative and deserves evaluation. Methods: The medical records of 52 consecutive patients with renal gunshot wounds, who were managed between September 1994 and August 1995 by a protocol of selective exploration, were reviewed. Renal injuries were explored only if they involved the hilum or were accompanied by signs of continued bleeding. Main outcome measures were the numbers of kidneys lost, as well as the morbidity and mortality related to the management of the renal injury. Results: Three patients died from associated injuries shortly after admission. Fifteen patients suffered complications but only two had complications directly associated with the renal injury. Thirty-two patients underwent renal exploration and 17 of them required nephrectomy for major renovascular or parenchymal trauma (grade IV and V). Renal exploration was successfully avoided in the remaining 20 patients. No kidneys were lost unnecessarily as a result of this policy. Conclusion: Mandatory exploration of all gunshot wounds to the kidney is not necessary. Injuries that produce stable peripheral haematomas do not require exploration.

Original languageEnglish
Pages (from-to)1121-1124
Number of pages4
JournalBritish Journal of Surgery
Volume85
Issue number8
DOIs
StatePublished - 1998
Externally publishedYes

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Gunshot Wounds
Kidney
Wounds and Injuries
Nephrectomy
Hematoma
Medical Records
Outcome Assessment (Health Care)
Hemorrhage

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Velmahos, G. C., Demetriades, D., Cornwell, E. E., Belzberg, H., Murray, J., Asensio, J. A., & Berne, T. V. (1998). Selective management of renal gunshot wounds. British Journal of Surgery, 85(8), 1121-1124. https://doi.org/10.1046/j.1365-2168.1998.00798.x

Selective management of renal gunshot wounds. / Velmahos, G. C.; Demetriades, D.; Cornwell, E. E.; Belzberg, H.; Murray, J.; Asensio, Juan A.; Berne, T. V.

In: British Journal of Surgery, Vol. 85, No. 8, 1998, p. 1121-1124.

Research output: Contribution to journalArticle

Velmahos, GC, Demetriades, D, Cornwell, EE, Belzberg, H, Murray, J, Asensio, JA & Berne, TV 1998, 'Selective management of renal gunshot wounds', British Journal of Surgery, vol. 85, no. 8, pp. 1121-1124. https://doi.org/10.1046/j.1365-2168.1998.00798.x
Velmahos GC, Demetriades D, Cornwell EE, Belzberg H, Murray J, Asensio JA et al. Selective management of renal gunshot wounds. British Journal of Surgery. 1998;85(8):1121-1124. https://doi.org/10.1046/j.1365-2168.1998.00798.x
Velmahos, G. C. ; Demetriades, D. ; Cornwell, E. E. ; Belzberg, H. ; Murray, J. ; Asensio, Juan A. ; Berne, T. V. / Selective management of renal gunshot wounds. In: British Journal of Surgery. 1998 ; Vol. 85, No. 8. pp. 1121-1124.
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