<prompt> During renal rupture the nephrectomy is NOT attempted untilFluid replacementAntibiotics coversContralateral renal function is ascertainRenal angiogram  <response>: Contra-lateral renal function is scertainNephrectomy is a possibility so it is important to establish that the contralateral kidney is functioning 1291- Bally Love 25thInjury to the Kideny Haematuria is a cardinal sign of a damaged kidney Meterorism - abdominal distension comes on about 24-48 hours after the accident retroperitoneal haematoma implicating splanchnic nerves An Intravenous urogram IVP should be obtained urgently to show that the other kidney is normal. A leak of urine on the damaged side is often demonstrated Before proceeding to surgical procedure for bleeding a renal arteriogram should be performed if possible. If the bleeding vessel is visualized it may be embolised with small starch microspheres to stop bleeding Should the necessity for a urgent operation arise and facilities for urography not be available, the presence of a functioning kidney on the contralateral side can often be confirmed by chromo- cystoscopyTREATMENT1. Nephrectomy - Kidney is found to rupture in several places or kidney pedicle is damaged2. Small tear can be sutured over oxycel or a piece of detached muscle3. Nephrostomy - Larger single rents in the middle of the kidney4. Partial Nephrectomy - laceration is confined to one pole of the kidney 