Intermediate-degree blunt renal trauma.

One hundred four cases of blunt renal trauma have been reviewed and analyzed, yielding 71 minor, 13 major, and 20 intermediate-degree injuries. Of the latter group, urinary extravasation (60%) and parenchymal laceration (100%) appear to be the dominant features exhibited by conventional radiographic maneuvers, neither of which suggest a de novo need for operation or interference with spontaneous resolution. Nephrectomy (9) and heminephrectomy (2) may often have been performed unnecessarily in this group, since nine such patients managed either nonoperatively (7), or undergoing negligible operative procedures (2) responded with total functional and anatomic restoration. Arteriography is endoresed as an important contributor of information encouraging conficdence in the conservative management of such cases.