Renal trauma

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The kidney is injured in up to 10% of patients who sustain significant abdominal trauma. Overall about 65% of genitourinary (GU) injuries involve the kidney. It is the most commonly injured GU organ from civilian external trauma.
Most renal injuries (85 to 90% of cases) result from blunt trauma, typically due to motor vehicle crashes, falls, or assaults. Most injuries are low grade. The most common accompanying injuries are to the head, central nervous system, chest, spleen, and liver. Penetrating injuries usually result from gunshot wounds and are usually associated with multiple intra-abdominal injuries, most commonly to the chest, liver, intestine, and spleen.
Renal injuries are classified according to severity into 5 grades:

Grade 1: Subcapsular hematoma and/or renal contusion
Grade 2: Laceration ≤ 1 cm in depth without urinary extravasation
Grade 3: Laceration gt; 1 cm without urinary extravasation
Grade 4: Laceration involving the collecting system with urinary extravasation; any segmental renal vascular injury; renal infarction; renal pelvis laceration and/or ureteropelvic disruption
Grade 5: Shattered or devascularized kidney with active bleeding; main renal vascular laceration or avulsion