[Early revascularization by stent in renal pedicle trauma].

OBJECTIVES

Lesions of the renal pedicle after blunt trauma of the abdomen are rare, and the results of the various therapeutic approaches are unpredictable and usually disappointing. We therefore decided to evaluate an endovascular approach with stent placement in this indication.

CASE: A 50-year-old woman, after jumping out of a window, arrived in coma with multiple organ lesions, haemorrhagic shock and initial haemodynamic instability. Renal arteriography, performed 2 hours after the fall, showed complete dissection of the right renal artery. A stent was inserted. Revascularization was satisfactory on follow-up CT. The macroscopic haematuria initially present rapidly resolved. With a follow-up of 1 month, the kidney presented a normal morphology with a normal nephrogram and a normal excretion time.

CONCLUSION

In renal pedicle trauma, urgent elective nephrectomy in patients with a functional contralateral kidney now appears to be the most widely used treatment option, regardless of the interval since trauma. Treatment by vascular stent can be performed even in the context of serious multiple injuries, and the first attempts show encouraging results.