A 28-year-old man sustains a blunt left flank injury in a road traffic accident. He is haemodynamically stable with microscopic haematuria. Contrast CT shows a 1.8 cm parenchymal laceration of the left kidney with a small non-expanding perinephric haematoma, no urinary extravasation and normal enhancement of the kidney. According to the AAST organ injury scale, this renal injury is graded as:
- A Grade I
- B Grade III ✓
- C Grade II
- D Grade IV
Correct answer: B. Grade III
Explanation
Grade III is a parenchymal laceration deeper than 1 cm without extension into the collecting system and without urinary extravasation. Grade II is limited to lacerations less than 1 cm deep, so option C fails on depth. Grade IV requires collecting system involvement with urinary leak or a segmental vascular injury, neither of which is present here. Stable grade III injuries are managed conservatively.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.