[Usefulness of computed tomography for the staging and management of post-traumatic renal lesions]

Use of computerized tomography (CT) criteria for the staging of 50 cases of renal trauma diagnosed in the Hospital General Universitario "Gregorio Marañón" over the 1989-1995 period. CT is used as the choice technique to diagnose renal lesions of traumatic etiology in patients haemodynamically stable.

Retrospective study of 50 patients (age range: 16-73 years; sex distribution: 39 male/11 female) with a history of abdominal trauma and CT-confirmed renal injury. Following Hodges-Federle criteria for patients with no underlying renal disease (n = 44), lesions are staged into 4 categories or grades according to CT findings. The traumatic mechanism is correlated to clinical semiology, staging and associated extrarenal lesions. Also, traumatic renal lesions in patients with previously diseased kidneys (n = 6) are analyzed separately.

Percentile distribution of lesions was as follows: grade I: 50% (n = 22), grade II: 29.5% (n = 13): grade III: 11.4% (n = 5): grade IV: 9.1% (n = 4). Compared to others, our series shows a decreased percentage of mild or grade I lesions. It is confirmed that CT is a very valuable imaging method for an adequate staging of post-traumatic renal lesions, the diagnosis of associated extra-renal lesions and, therefore, for the subsequent therapeutical management.