Renorrhaphy Using Pledgeted Sutures for Grade IV Renal Trauma

The wire under construction hit the right back of a 56-year-old male (Fig. 1). Upon admission, the patient’s blood pressure was 92/59 mm Hg, pulse rate was 125 beats/min, and he had been transfused with 2 units of packed red blood cell. The focused assessment with sonography for trauma revealed intra-abdominal fluid collection in the Morison pouch. Abdomen computed tomography (CT) performed in response to resuscitation demonstrated multiple laceration at the Couinaud segment V, VI, and VII of the liver, and multiple lacerations deep to the calyx in the right kidney with the contrast extravasation (Fig. 2). The injury severity score was 26. Therefore, he underwent emergency laparotomy due to intermittent hypotension. Right renorrhaphy with temporary renal vascular pedicle clamping after the temporary perihepatic packing was performed with transfusion of 2 units of packed red blood cell during How to Do It in Trauma eISSN: 2508-8033 pISSN: 2508-5298