A case of a stab wound to a left solitary kidney

A forty-four-years old man with a left solitary kidney presented a stab wou nd in the left lumbar region. Upon admission, the patient was hemodynamical ly stable, the abdominal ultrasonography showed a small perirenal hematoma and the intravenous pyelography was normal. Two days later, he had no hemat uria and was discharged from the hospital, with a computed tomography scan control two weeks later. Unfortunately, seven days later, the patient was a dmitted to emergency for left lumbar pain, a 40 degrees C fever and pyuria. The creatinine level was 72 ng/mL, and the computed tomography scan showed a large urohematoma. The patient was operated and required partial upper p olar nephrectomy for distorted upper pole with infected hematoma. A large h ematoma was removed and a nephrostomy tube was introduced. The renal functi on returned to normal six days postoperatively and the nephrostomy tube was removed after nephrostogram at 12 days. Concerning this uncommon case, we emphize the advantage of the computed tomography scan and the necessity of emergency management in a patient with solitary traumatic kidney. (C) 2000 Editions scientifiques et medicales Elsevier SAS.