Prise en charge des traumatismes sévères du rein de l'adulte. Mise au point pratique

The conservative approach for the treatment of severe blunt renal traumas increased considerably because of progress in the initial assumption and care of these patients. This non-surgical evolution is the consequence of a good collaboration between the urologists, the other surgeons implied in the management of the secondary lesions and the intensive care units; it is also the result of a more standardized, rapid and exhaustive initial assessment of the patient by CT scan, and the development of interventional radiology and the endoscopic procedures on the urinary tract. The objective of this paper is to point out the various phases of the initial care of these patients, with a simplified algorithm, which summarizes the place of the various actors of this multidisciplinary assumption of responsibility. This document must also reflect on the place of the surgery in these severe traumas, often carried out when the vital risk is concerned, generally leading to a nephrectomy.