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• It is necessary to classify cystic disorders of the kidney with care because the prognoses of the various entities are quite different, depending on the type of the cysts, whether single or multiple, unilateral or bilateral, simple or complicated, painful or asymptomatic. The nature of the liquid found in the cyst helps to decide whether the lesion is to be considered malignant. Gross specimens, schematic diagrams, and pyelograms are shown to illustrate simple cyst, unilateral cyst with papillary carcinoma visible on part of the wall, cyst secondary to tuberculous pyelonephritis, bilateral familial diffuse cystic disease with preservation of the reniform organ contours and of functioning nephrons, unilateral cystic disease with destruction of both form and function, and other types of cysts that surround all or part of the kidney. The experiences of the authors lead to the conviction that the standard treatment of bilateral familial polycystic disease of the kidneys remains medical except when specific complications exist.

The purpose of this paper is to present a plan of management of kidney injuries that has been evolved from our experiences in civilian urologic practice. From an analysis of 66 cases and a review of articles in the recent literature, certain observations seem warranted. When confronted with a patient who may have sustained trauma to the kidney, the initial problem is to determine whether the kidney actually has been injured. Significant pain or tenderness in the renal area, gross hematuria, and/or a mass in the flank constitute presumptive evidence of kidney involvement, and if present it then becomes the duty of the physician to determine the extent of the injury. Once this has been ascertained, logical treatment may be started. Of paramount importance is knowledge of the status of the other kidney. It should be remembered that concomitant damage to other viscera, such as the liver, bowel, or spleen