Selective Arterial Embolization for Persistent Urinoma Following Traumatic Renal Injury: A Case Report and Review of the Literature.

Traumatic and iatrogenic renal injuries, particularly high-grade trauma and complications following nephron-sparing surgeries, pose significant clinical challenges. Complications such as urinomas, pseudoaneurysms, and arteriovenous fistulas (AVFs) can lead to serious morbidity if not promptly addressed. Selective arterial embolization (SAE) has emerged as a minimally invasive alternative to surgery, offering effective hemorrhage control while preserving renal function. We report the case of a 51-year-old male patient who sustained a Grade V shattered left kidney following blunt trauma. The patient underwent emergency laparotomy with left nephrectomy. Postoperatively, a persistent urinoma developed from a retained kidney remnant. SAE was successfully performed to manage this complication, achieving complete resolution without further surgical intervention. SAE demonstrates high technical success and clinical efficacy in treating renal vascular complications after trauma or surgery. It offers the advantages of nephron preservation, reduced morbidity, and adaptability through various embolic agents. Despite risks such as post-embolization syndrome and potential non-target embolization, SAE remains the preferred approach in hemodynamically stable patients or those at high risk for reoperation. Early diagnosis and timely intervention are essential for optimal outcomes. SAE is a safe, effective, and nephron-sparing treatment modality for complex renal vascular injuries and complications. It should be considered a first-line therapeutic option in appropriate clinical settings, especially when surgical reintervention poses high risks.