The World Society of Emergency Surgery (WSES) has reported guidance for management of renal trauma.

Patient selection: blunt or penetrating injury to the kidney


Indications for laparotomy:

(1) hemodynamic instability (WSES IV)

(2) transient response to resuscitation

(3) non-self-limiting bleeding from main renal vessels

(4) other indications for laparotomy seen on contrast-enhanced CT scan

(5) ineffective endovascular management

(6) ineffective angioembolization

(7) hemodynamic instability during non-operative management


Indications for angioembolization:

(1) blush seen on contrast-enhanced CT scan


Non-operative management requires expertise and ready access to diagnostic and therapeutic modalities. It is often appropriate for WSES I, II or III grade injuries, including those after effective angioembolization.

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