Published 2023-01-10
Ahmad Nurfakhri Syarief Fikri Rizaldi


Objective: This study aims to report the possibility of non-operative management (NOM) as a Renal artery thrombosis (RAT) treatment. Case(s) Presentation: In this series, we reported 3 cases of unilateral RAT secondary to blunt abdominal trauma treated with NOM, where patient had complete bed rest, close observation, laboratory tests, and serial imaging. During a first-month follow-up, hypertension, renal abscess, persistent flank pain, or impairment of renal function were not found in the patients. However, after a one-year follow-up, an atrophic kidney appeared due to RAT in one of our cases. Discussion: RAT secondary to blunt abdominal trauma is rare. However, the management of RAT is still controversial. Renal preservation with NOM possesses reasonable success because the risk of complication does not exceed that of revascularization, and is currently considered. Conclusion: NOM is considered a treatment option in the cases of unilateral RAT with good contralateral renal function. This treatment provides a minimal number of complications. Keywords:  Renal artery thrombosis, non-operative management.  



Renal artery thrombosis, Non-operative management


Erlich, T. & Kitrey, N. D. Renal trauma : the current best practice. Ther Adv Urol.

: 1-9.

Patel, P., Hospital, S. C. & Duttaroy, D. Management of renal injuries in blunt abdominal

trauma Original Article Management of renal injuries in blunt abdominal trauma. 2014.

Austin, J. & Rajkumar, G. The diagnosis and management of renal trauma. J Clin Urol.

Jawas, A. & Abu-Zidan, F. M. Management algorithm for complete blunt renal artery

occlusion in multiple trauma patients: Case series. International Journal of Surgery. 2008;

: 317–322.

Singh, O., Gupta, S. S., Sharma, D., Lahoti, B. K. & Mathur, R. K. Isolated renal artery

thrombosis because of blunt trauma abdomen: report of a case with review of the

literature. Urol Int. 2010; 86: 233–238.

Sangthong, B. et al. Management and hospital outcomes of blunt renal artery injuries:

analysis of 517 patients from the National Trauma Data Bank. J Am Coll Surg. 2006;

: 612-617.

Kitrey, N. et al. EAU Guidelines on Urological Trauma. European Association of

Urology. 2022.

Nugraha, H. G. et al. Post-traumatic renal artery thrombosis secondary to blunt abdominal

trauma: A rare case report. Bali Medical Journal. 2021; 10: 587–590.

Szmigielski, W., Kumar, R., al Hilli, S. & Ismail, M. Renal trauma imaging: Diagnosis

and management. A pictorial review. Polish Journal of Radiology. 2013; 78: 27–35.

Lee, J. T. & White, R. A. Endovascular management of blunt traumatic renal artery

dissection. Journal of Endovascular Therapy. 2002; 9: 354–358.

Li, G., Gao, Y., Li, P. & Li, M. Renal Artery Thrombosis Secondary to Blunt Abdominal

Trauma with Accessory Renal Artery Supplying the Kidney Segment: A Rare Case

Report. Urol J. 2015; 12: 2044–2045.

Harper, K. & Shah, K. H. Renal trauma after blunt abdominal injury. J Emerg Med. 2013;

: 400–404.

Shoobridge, J. J. et al. Contemporary management of renal trauma. Rev Urol. 2011; 13:

Kitrey, N. D. et al. EAU guidelines on urological trauma. European Association of

Urology. 2021. p. 1–50.

Ahmed, Z. et al. Renal artery injury secondary to blunt abdominal trauma – Two case

reports. Pol J Radiol. 2016; 81: 572–577.

Santucci, R. A. et al. Evaluation and management of renal injuries: consensus statement

of the renal trauma subcommittee. 2004.

Van der Wilden, G. M. et al. Successful Nonoperative management of the most severe

blunt renal injuries: A multicenter study of the research consortium of new england

centers for trauma. JAMA Surg. 2013; 148: 924–931.

McCombie, S. P. et al. The conservative management of renal trauma: A literature review

and practical clinical guideline from Australia and New Zealand. BJU International.

; 114: 13–21.

Alnahhal, K. I., Jarmi, T., Hakaim, A. G. & Farres, H. Renal artery revascularization

using the inferior mesenteric artery as an inflow source with a long-term follow-up.

Journal of Vascular Surgery Cases, Innovations and Techniques. 2021; 7: 223–225.

Tillou, A. et al. Renal vascular injuries. Surgical Clinics of North America. 2021; 81:


Jackson, D. G. et al. Kidney Salvage with Renal Artery Reconstruction after Blunt

Traumatic Injury. Case Rep Urol. 2020; 1–4.

Jeong, Y., Kim, S., Lee, H. & Sim, J. Atypical Low-Signal-Intensity Renal Parenchyma:

Causes and Patterns. 2002.

Copyright Information
Department of Urology, Faculty of Medicine/Airlangga University