Manejo conservador en trauma renal contuso. Algunas recomendaciones para recordar

Topic summary: Management of blunt renal trauma is based on clinical and laboratory surveillance within the first 24 hours. Multiphase computed tomography is the imaging study of choice and should initially be carried out in all patients with suspected renal trauma and repeated only in cases of clinical deterioration. Prophylaxis or pneumatic compression should be utilized in patients with risk factors for thrombosis, in whom heparin use is contraindicated. A definitive consensus has not been reached on the use of antibiotic therapy, but it is recommended in patients with signs of acute infection. Relevance: There is a significant prevalence of renal trauma worldwide and it accounts for 5% of trauma patients in the Colombian environment. Given that there are few evidence-based recommendations, conservative management is preferred, even in patients with high-grade trauma. Conclusions: Conservative management is recommended in grade I-IV blunt renal trauma, whereas treatment in grade V injury is still subject to debate. Antibiotic prophylaxis should be avoided, given the low infection rate, but antibiotic use is indicated when there are clinical signs of infection.