44 ROUTINE ABDOMINAL COMPUTER TOMOGRAPHY SCAN MAY RESULT IN UNNECESSARY RADIATION EXPOSURE OF CHILDREN PRESENTING WITH BLUNT ABDOMINAL TRAUMA AND MICROHEMATURIA

Abstract

You have accessJournal of UrologyTrauma/Reconstruction: Trauma & Reconstructive Surgery I1 Apr 201044 ROUTINE ABDOMINAL COMPUTER TOMOGRAPHY SCAN MAY RESULT IN UNNECESSARY RADIATION EXPOSURE OF CHILDREN PRESENTING WITH BLUNT ABDOMINAL TRAUMA AND MICROHEMATURIA Miki Haifler, Orit Raz, Laurian Copel, Erez Lang, Helio Sipela, Yaniv Shilo, Ibrahim Abu Kishck, Baruch Klein, Arie Lindner, and Amnon Zisman Miki HaiflerMiki Haifler More articles by this author , Orit RazOrit Raz More articles by this author , Laurian CopelLaurian Copel More articles by this author , Erez LangErez Lang More articles by this author , Helio SipelaHelio Sipela More articles by this author , Yaniv ShiloYaniv Shilo More articles by this author , Ibrahim Abu KishckIbrahim Abu Kishck More articles by this author , Baruch KleinBaruch Klein More articles by this author , Arie LindnerArie Lindner More articles by this author , and Amnon ZismanAmnon Zisman More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.089AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES blunt renal trauma accounts for the majority of renal injuries in the pediatric population. abdominal CT scan is a valuable life-saving tool for the diagnosis of trauma in children but the inevitable radiation exposure remains a major disadvantage. The purpose of this study is to examine the yeild of abdominal CT scan while conservatively approaching pediatric renal trauma. METHODS from 1999 to 2007, 53 consecutive children were admitted for renal trauma, all had hematuria. the children were divided into two groups according to abdominal CT scan findings: group A: 29 children with hematuria and apparent anatomic renal injury, and group B: 24 with hematuria and no evidence for renal injury on imaging. RESULTS CT scan was able to totally discriminate between 6/29 patients who needed intervention versus those who did not 0/24, p=0.018. for all patients with microhematuria, regardless of imaging, none required blood transfusion and 31/33 (94%)were managed conservatively versus 16/20 (80%) with macrohematuria (p=0.121), representing 16.5 CT scans performed per one intervention in patients with microhematuria versus 4 ct scans per one intervention in patients with macrohematuria (ratio 3.9). no mortality was recorded in the entire cohort. one renal unit was lost in group A. multi-organ injury was recorded in 14 patients (48%) in group A versus 4 in group B (17%, p=0.016). CONCLUSIONS conservative treatment is afeasible approach in pediatric renal trauma at large. CT scan is able to accurately identify patients at risk for intervention. however, the yeild of abdominal CT in pediatric renal trauma is very low especially in patients presenting with microhematuria. ways should be found in order to cautiously limit the utilization of abdominal CT scan in children with microhematuria and blunt renal trauma in order to reduce radiation exposure. Beer Yaakov, Israel© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e18 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Miki Haifler More articles by this author Orit Raz More articles by this author Laurian Copel More articles by this author Erez Lang More articles by this author Helio Sipela More articles by this author Yaniv Shilo More articles by this author Ibrahim Abu Kishck More articles by this author Baruch Klein More articles by this author Arie Lindner More articles by this author Amnon Zisman More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...