A 20-year-old man is stabbed in the left flank. He is hemodynamynamically stable with no peritonism. CT abdomen with intravenous contrast shows a grade II renal injury (subcapsular haematoma less than 1 cm, no laceration) with an intact retroperitoneum. What is the appropriate management?
- A Emergency exploratory laparotomy
- B Conservative management with bed rest, serial hemoglobin, and monitoring ✓
- C Angioembolisation
- D Serial ultrasound examinations every 6 hours
Correct answer: B. Conservative management with bed rest, serial hemoglobin, and monitoring
Explanation
Low-grade renal injuries (grades I and II) in hemodynamically stable patients are managed conservatively with bed rest, close hemodynamic monitoring, and serial hemoglobin checks. Angioembolisation is considered for active extravasation or pseudoaneurysm. Operative exploration is reserved for grade V injuries, hemodynamic instability, or expanding pulsatile retroperitoneal haematoma.
Reference: Schwartz's Principles of Surgery, 11th ed.
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