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[Radiological findings in severe renal trauma during childhood (author's transl)]
Insights
Radiological imaging is crucial for diagnosing severe renal trauma in children. Contrast extravasation on excretory urography reliably indicates kidney rupture, guiding treatment decisions.
Area of Science:
- Pediatric Radiology
- Urologic Imaging
- Trauma Imaging
Background:
- Severe renal trauma in children presents diagnostic challenges.
- Accurate radiological assessment is vital for appropriate management.
Purpose of the Study:
- To describe radiological findings in pediatric renal trauma.
- To evaluate the diagnostic value of various imaging modalities.
Main Methods:
- Review of radiological findings in 21 children (4-14 years) with severe renal trauma.
- Analysis of plain films, excretory urography, and angiography.
Main Results:
- Plain films offer non-specific evidence of renal trauma.
- Contrast extravasation during excretory urography is the sole reliable sign of rupture.
- Immediate angiography is indicated for non-excreting kidneys to rule out vascular damage.
Conclusions:
- Excretory urography with contrast extravasation is key for diagnosing renal rupture.
- Angiography is essential in cases of non-excretion, persistent hematuria, or diagnostic uncertainty.
- Regular follow-up is necessary to detect complications post-treatment.
Abstract:
The radiological findings in 21 children aged between four and 14 years, suffering from severe renal trauma, are described. Various radiological signs are described and their value and frequency are discussed. Plain films provide only non-specific evidence. Contrast extravasation during an excretions urogram is the only reliable sign of rupture. Immediate angiography in order to exclude vascular damage is indicated if there is no contrast excretion by the damaged kidney. Angiography at a later date should be carried out if there is persistent haematuria, in cases of doubt regarding the excretion urogram, or when it is impossible to decide on the basis of the excretion urogram whether operative or conservative treatment is indicated. Regular observation is necessary, both after operative and conservative treatment, in order to recognise complications at an early stage.