Computed Tomography in Evaluation of Blunt Renal Trauma

Abstract

Over one and half years, 16 patients admitted to this hospital with the diagnosis of blunt renal trauma were selected to perform computed tomography (CT) scanning. By the CT, renal injuries were categorized into minor and major injury. The minor in-juries included contusion of the kidney, shallow cortical laceration and forniceal disrup-tion. The major injuries consisted of renal pedical injury, deep laceration (into medulla), multiple lacerations (shattered kidney) and collecting system injury. There were 4 pa-tients with minor injuries and 12 ptients with major injuries in the CT finding. Among the 16 patients, only 4 patients could not achieve stable vital signs despite massive blood transfusion and finally they must receive surgical exploration for life sav-ing. These 4 patients were all in the group of major injury, of them 1 with deep lac-eration and the other 3 with multiple lacerations (shattered kidney). All of the 4 surgical patients and only 1 of 12 conservative treatment patients were present pararenal hematoma. The outcome of the patients were all good success. In conclusion, the CT findings will be helpful to the urologist to make decision for management of renal trauma. If the CT scanning revealed major injuries associat-ed with pararenal hematoma, surgical exploration for life saving must be considered. (J Urol R.O.C., 2:392-397, 1991)