Penetrating renal injuries and the management of renal pedicle injury.

Injury to the upper urinary tract from penetrating trauma frequently is associated with injury to other abdominal organs. Management of the renal injury requires knowledge of the effect of injury of these other organs on the renal repair. Frequently the associated injury may dictate a need for nephrectomy when a complicated procedure would be necessary for repair of the kidney, but one should always keep in mind the high incidence of acute renal failure found in penetrating abdominal injuries and make a maximum effort to converse renal parenchyma in these patients. If renal repair is attempted, watertight repair of the renal collecting system, adequate debridement of injured renal tissue, accurate assessment of the presence or absence of blast effect, meticulous hemostasis, and adequate drainage are imperative.