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CT Findings in Blunt Renal Trauma¹

¹ From the Department of Radiology, Vancouver General Hospital, 855 W 12th Ave, Vancouver, British Columbia, Canada V5Z 1M9. Presented as an education exhibit at the 2000 RSNA scientific assembly. Received February 2, 2001; revision requested April 5 and received May 10; accepted May 29. Address correspondence to C.V.Z. (e-mail: zwirecv@unixg.ubc.ca).

Computed tomography (CT) can provide essential anatomic and physiologic information required to determine management of intraabdominal and retroperitoneal injuries sustained during blunt abdominal trauma. It can help in evaluation of the type and severity of parenchymal injury, the extent of perirenal hemorrhage and parenchymal devascularization, and the presence of urinary extravasation. CT can help confirm the presence of major injuries to the vascular pedicle and depict occult renal pathologic conditions. Principal indications for the use of CT in the evaluation of blunt renal trauma include (a) the presence of gross hematuria, (b) microscopic hematuria associated with shock (systolic blood pressure <90 mm Hg), and (c) microscopic hematuria associated with a positive result of diagnostic peritoneal lavage. The majority of renal injuries sustained during blunt abdominal trauma are contusions and minor parenchymal lacerations amenable to nonoperative management. Deep parenchymal lacerations, urinary extravasation, and mild to moderate degrees of parenchymal devascularization may also be treated conservatively. Radiologists should look for coexisting renal lesions such as tumors and traumatic false aneurysms that may alter management.

Index Terms: Kidney, CT, 81.12114 • Kidney, hemorrhage, 81.413 • Kidney, infarction, 81.77 • Kidney, injuries, 81.41, 81. 482

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