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Imaging of renal trauma
J Kevin Smith1, Philip J Kenney
1Department of Diagnostic Radiology, University of Alabama at Birmingham Health System, 619 South 19th Street, Birmingham, AL 35233, USA. jksmith@uabmc.edu
Radiologic Clinics of North America
|October 3, 2003
Summary
Renal trauma occurs in 10% of blunt abdominal trauma patients. CT scans are crucial for diagnosing urinary tract injuries, guiding treatment from conservative management to surgery.
Area of Science:
- Trauma Surgery
- Urology
- Diagnostic Imaging
Background:
- Trauma is a leading cause of death and disability.
- Renal injuries affect up to 10% of patients with blunt abdominal trauma.
- Prompt diagnosis and management are critical for patient outcomes.
Purpose of the Study:
- To outline the diagnostic approach to renal trauma.
- To categorize the severity of renal injuries.
- To discuss management strategies for various renal trauma presentations.
Main Methods:
- Computed tomography (CT) is the preferred imaging modality for suspected renal injuries.
- Specific indications for imaging include penetrating trauma with hematuria, blunt trauma with shock and hematuria, or gross hematuria.
- Delayed imaging may be necessary to detect urinary extravasation.
Main Results:
- Most renal injuries are minor (contusions, hematomas, superficial lacerations).
- Significant injuries include deep lacerations, shattered kidney, active hemorrhage, and vascular pedicle/UPJ injuries.
- Urinary extravasation and devitalized parenchyma often necessitate surgical intervention.
Conclusions:
- Renal trauma management ranges from conservative care to urgent surgical intervention or embolization.
- Active hemorrhage is a key indicator for urgent treatment to prevent exsanguination.
- Early recognition of injury patterns guides appropriate and timely management decisions.