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Blunt injury of the abdomen: a plea for CT.

S K Chowdhary¹, A Pimpalwar, K L Narasimhan

¹Department of Paediatric Surgery, Advanced Paediatric Centre, PGIMER, India. sujitchowdhary@hotmail.com

Pediatric Radiology

|December 2, 2000

Summary

A child with blunt trauma developed a subtle indirect sign of renal artery occlusion on CT scan. Prompt recognition is crucial, especially in cases of solitary kidneys, to prevent severe complications.

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Area of Science:

Radiology
Pediatric Imaging
Trauma Imaging

Background:

Blunt abdominal trauma in children can cause significant internal injuries.
Early diagnosis of renal trauma is essential for appropriate management and preventing complications.

Observation:

A 3-year-old boy presented with free intraperitoneal fluid on ultrasound after deceleration injury.
Contrast-enhanced CT revealed absent right kidney enhancement with delayed contrast in the renal vein.

Findings:

The presence of contrast in the renal vein, with absent renal parenchymal enhancement on delayed scans, is an indirect sign of post-traumatic renal artery occlusion.
This finding suggests a complete blockage of blood flow to the kidney.

Implications:

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Misdiagnosis of renal artery occlusion can lead to irreversible kidney damage, particularly in patients with a solitary kidney or bilateral involvement.
Contrast-enhanced CT is a vital tool for accurately staging blunt renal trauma and guiding clinical decisions.