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Question 4#

When can penetrating injuries to the kidney be considered for non-operative management?

A. Knife entry point anterior to anterior axillary line in a stable patient
B. Gunshot injury to flank
C. Knife entry point posterior to anterior axillary line in a stable patient
D. Blast and fragment injury to flank
E. None of the above

Correct Answer is C


Answer C

Operative exploration has traditionally been recommended for penetrating injuries. However, if a knife entry point is posterior to the anterior axillary line, then the likelihood of renal hilar injury or associated visceral injury is low. High-resolution CT is leading to an increase in the non-operative management of this patient group. Low-velocity gunshot wounds can also be managed non-operatively.