Learning objectives
- Discuss the role and indications of imaging methods,
namely contrast-enhanced CT,
in renal trauma;
- Review the imaging signs of renal parenchymal,
vascular or collecting system injuries andthe AAST classification for renal trauma;
- Describe the main complications of renal trauma.
Background
The kidney is an organ commonly injured in the traumapatient.
The lesions can result most commonly from blunt,
but also from penetratingtrauma.
Contrast-enhancedCT is the most used technique in the evaluation of renal trauma due to its sensitivity in depicting renal as well as other abdominal injuries,
but also for being widely available near emergency units.
The AAST grading system is a widely used classification based on surgical findings and shows good correlation both with CT findings and prognosis.
Findings and procedure details
RENAL TRAUMA
Kidney damage is a major concern in any abdominal trauma.
In fact,
about 10% of abdominal traumas result in some extent of renal injury,
even though majority of lesions will be minor.
Ultrasound might be the first approach in several centers due to its non-invasiveness,
portability and promptness to be used in the emergency department.
Nevertheless,
contrast-enhanced CT is the modality of choice in the evaluation of renal trauma due to its accuracy in the detection of this and other abdominal/retroperitoneal injuries,
active...
Conclusion
Contrast-enhanced CT is the modality of choice in the evaluation of renal trauma.
Identification of the imaging signs of renal trauma is mandatory for every radiologist.
Knowing theAAST grading system is important for rapid and adequate communication between the surgeon and the radiologistas well as for the radiologist torecognizewhich imaging signs are more important and deserve to be highlighted in the CT report.
References
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Nacenta S.,
Martinez P.,
Guerrero A.,
Fuentes C.
Kidney in danger: CT findings of blunt and penetrating renal trauma.
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2009;29:2033–2053;- Buckley JC,
McAninch JW.
Revision of current American Association for the Surgery of Trauma Renal Injury grading system.
J Trauma.
2011;70:35–3;- Dayal M.,
Gamanagatii S and Jumar,
A.
Imaging in renal trauma.
World J Radiol.
2013; 5(8): 275-284;- Jankowski J.,
Spirnak J.
Current recommendations for imaging in the management of urologic traumas.
Urol Clin North Am.
2006;33:365–376;- Kawashima A.,
Sandler C.,...