Renal Trauma: Evaluation by Computerized Tomography

Abstract

The diagnosis and appropriate management of patients with renal trauma have remained controversial. From July 1981 to June 1984 we evaluated with computerized tomography 22 selected patients suspected of sustaining major renal trauma. Of these patients 17 were managed successfully with conservative therapy and 5 underwent surgical exploration. Only 2 patients required arteriography because of excellent renal delineation provided by computerized tomography scanning. Computerized tomography provides the most precise anatomical detail of renal injuries as well as valuable information regarding other retroperitoneal and intra-abdominal structures, often resulting in the identification of associated and unsuspected injuries. We advocate the use of computerized tomography as the primary diagnostic modality in patients suspected of sustaining major renal injury and/or other organ injuries. This change in diagnostic studies has facilitated greatly the diagnosis and treatment of kidney injuries.

Evaluation and management of renal injuries: consensus statement of the renal trauma subcommittee

“…Non‐visualization, contour deformity or extravasation of contrast medium implies a major renal injury and should prompt further radiographic evaluation with CT or angiography. The accuracy of IVU and CT has been estimated to be 65–95% in different series, depending on the mechanism of injury [5,6,27,33,70,82]. In patients with renal‐proximity stab wounds, IVU as the first diagnostic study was 96% accurate in establishing the presence or absence of injury [45].…”

Focal Xanthogranulomatous Pyelonephritis: Diagnostic and Therapeutic Aspects

“…There is now a spectrum of renal masses, solid, liquid or intermediate, i.e., oncocytoma [10], angiomyolipoma [19], hematoma [20], abscesses and anthrax [21,22], with different biolog ical behavior conditions and therapeutic strategies rang ing from radical demolition to 'nephron-sparing' surgery. The focal XGP.…”

Pediatric Blunt Renal Trauma - Surgical or Conservative Treatment?

“…It provides the surgeon with precise information about the vascular situation and the perfu sion of the parenchyma and possible rupture planes. Conventional CT scan readily picks up associated ab dominal and retroperitoneal injuries and therefore has advantages in posttraumatic acute abdomen [3,9,19], A very valuable method is the dynamic CT scan with intra venous bolus injection of contrast medium, which is very sensitive and reliable in lacerations of the parenchyma and especially the collecting system, where it allows a discrimination between perirenal hematoma, urinoma and traumatized tissue [15].…”