A CASE OF SEVERE BLUNT KIDNEY INJURY REQUIRING REMOVAL OF THE KIDNEY AFTER CONSERVATIVE TREATMENT

Abstract

　　A 20-year-old male was admitted to our hospital with the complaint of left lateral abdominal pain following a motorcycle crash. He presented hemorrhagic shock. Contrast-enhanced CT (CE-CT) revealed severe renal trauma and extravasation of contrast medium. On the basis of a clinical diagnosis of hemorrhagic shock with severe renal trauma, we decided to treat the patient with the therapy of interventional radiology (IVR). Three days after the injury, his anemia and abdominal pain became worse, and CE-CT showed extravasation and renal trauma. We performed IVR and a single-J ureteral catheter was inserted. After the therapy, the patient was doing well, so the catheter was removed fourteen days after the injury. However, sixteen days after the injury, CE-CT showed extravasation and renal trauma again, and twenty days after the injury, the patient complained of abdominal pain and CE-CT showed that the renal trauma had worsened. We gave up on the conservative treatment and, twenty-one days after the injury, we undertook an operation to remove his left kidney.