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Intravenous pyelography in penetrating trauma
1Department of Surgery, University of Southern California, School of Medicine, Los Angeles.
The American Surgeon
|June 1, 1994
Summary
Intravenous pyelograms (IVPs) may not be necessary for all trauma patients. This study suggests that negative urinalysis in penetrating trauma cases might indicate omitting IVPs, potentially reducing costs and delays.
Area of Science:
- Urology
- Radiology
- Trauma Surgery
Background:
- Intravenous pyelograms (IVPs) are standard for evaluating urologic injuries after trauma.
- Clear indications for IVP use in trauma patients are not well-established.
Purpose of the Study:
- To evaluate the diagnostic utility of IVPs in patients with penetrating trauma.
- To determine if IVPs are necessary in cases with negative urinalysis.
Main Methods:
- Retrospective review of 67 patients with penetrating trauma who underwent IVPs with nephrotomography.
- Analysis of IVP findings correlated with urinalysis results and subsequent interventions.
Main Results:
- In patients with stab wounds, those without hematuria had only one positive IVP, requiring no intervention.
- In patients with gunshot wounds, negative urinalysis was associated with a low rate of positive IVPs and no significant renal injuries.
- Omitting IVPs in patients with negative urinalysis did not result in missed significant injuries in this cohort.
Conclusions:
- Negative urinalysis in penetrating trauma patients may suggest that IVPs can be safely omitted.
- Current IVP protocols may lead to unnecessary expenses and delays.
- Further research is warranted to refine IVP indications in trauma settings.