In patients with renal trauma, immediate surgical exploration is required in which of the following scenarios?a. Patients requiring blood transfusion
Immediate surgical exploration is only required in patients with haemodynamic instability despite adequate resuscitation. Blood products can be used in the resuscitation phase and allow successful conservative management or angioembolisation. Grade 4 renal trauma should be managed without surgical intervention in the majority of cases. Bilateral injuries are a good indication for ultraconservative management, as the likelihood of nephrectomy increases dramatically with surgical intervention.