[Kidney trauma in children: state of the art medical imaging]

Area of Science:

• Pediatric Radiology
• Urologic Imaging
• Trauma Imaging

Background:

• Traumatic renal lesions present unique challenges in pediatric patients due to anatomical differences.
• Accurate diagnosis and staging are crucial for appropriate management of pediatric renal trauma.
• Imaging plays a pivotal role in evaluating the extent and nature of these injuries.

Purpose of the Study:

• To highlight the specificities of traumatic renal lesions in children.
• To emphasize the importance of imaging modalities in diagnosis and staging.
• To outline the role of various imaging techniques in managing pediatric renal trauma.

Main Methods:

• Initial assessment with Doppler ultrasonography.
• Complementary use of renal Computed Tomography (CT) based on initial findings and trauma type.
• Comprehensive work-up utilizing combined imaging techniques for thorough evaluation.

Main Results:

• Doppler ultrasonography is the primary first-line examination in children, frequently enabling initial diagnosis.
• Renal CT serves as a complementary tool, providing detailed information when combined with ultrasound.
• The integrated approach allows for the detection of traumatic, associated, and pre-existing renal lesions.

Conclusions:

• Conservative management is the standard approach for most pediatric traumatic renal lesions.
• Interventional imaging techniques are valuable for specific therapeutic interventions, such as vascular or collecting system lesions.
• Post-trauma imaging facilitates monitoring of the morphologic and functional evolution of renal lesions, particularly excretory duct injuries.