Renal pedicle injury in the multiple injured patient.

Renal pedicle injuries were associated with multiple system trauma and a mortality rate of 42 per cent in 31 patients seen from 1959 to 1978. These injuries were to the renal artery in 14 patients, branches of the renal artery in 5, renal vein in 8, and renal artery and vein in 4. Priority of treatment for life-threatening associated injuries resulted in delayed diagnosis of the renal pedicle injury, which was not optimal for preservation of functioning renal tissues. Since 1968 an immediate excretory urogram has been performed for hematuria or a perirenal hematoma found during laparotomy for associated injuries. This study has resulted in the early diagnosis of renal pedicle injuries and immediate vascular repair has been attempted in 6 patients. Three of these patients survived with no hypertension on followup. A repaired renal vein in 1 patinet resulted in normal renal function and renal arteries were repaired in the other 2 patients with reduced renal function.