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Organo Oficial de la Sociedad Mexicana de Urología

2020, Número 5

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Rev Mex Urol 2020; 80 (5)


Manejo conservador en trauma renal contuso. Algunas recomendaciones para recordar

Franco-Buenaventura D, Uribe-Bayona AJ, García-Perdom HA

Idioma: Español
Referencias bibliográficas: 44
Paginas: 1-11
Archivo PDF: 138.21 Kb.


RESUMEN

Descripción resumida del tema: El manejo en trauma renal contuso se basa en la vigilancia clínica y paraclínica durante las primeras 24 horas. La imagen de elección es la tomografía axial computarizada (TAC) de múltiples fases. Se debe tomar en todo paciente con sospecha clínica de trauma renal y repetir sólo en caso de deterioro clínico. En pacientes con factores de riesgo para trombosis, se debe utilizar profilaxis o medias de compresión neumática en caso de contraindicación al uso de heparinas. No se ha llegado a consenso definitivo sobre el uso de antibioticoterapia, sin embargo, se recomienda en pacientes con signos de infección aguda.
Relevancia: El trauma renal es una enfermedad con una prevalencia importante a nivel mundial y en nuestro medio, presente en el 5% de los pacientes de trauma. Dadas las recomendaciones basadas en evidencia escasa, se prefiere el manejo conservador, incluso en pacientes con traumas de alto grado.
Conclusiones: Se recomienda el manejo conservador del trauma renal contuso grado I-IV. Aún existe controversia sobre el trauma renal grado V. Se sugiere evitar la profilaxis antibiótica dada la baja tasa de infección y se indica el uso de antibiótico en presencia de signos clínicos de infección.


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