Radiographic Assessment of Renal Trauma

Abstract

We sought to evaluate the continuing validity of our criteria for radiographic imaging of renal injuries, that is penetrating flank or abdominal trauma, blunt trauma with gross hematuria or microscopic hematuria and shock, deceleration or major associated abdominal injury and pediatric renal trauma. We reviewed the records of 2,254 patients who presented to our institution with suspected renal trauma between 1977 and 1992. Of the 1,588 blunt trauma patients with microscopic hematuria and no shock 3 had significant injury but these cases were discovered during imaging or exploratory laparotomy for associated injuries. Followup in 515 of 1,004 patients (51%) who did not undergo initial imaging revealed no significant complications. Adults with blunt renal trauma, microscopic hematuria and no shock or major associated intra-abdominal injuries can safely be spared radiographic imaging.