Grade IV renal injury
Motor vehicle collision.
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Left renal laceration predominantly involving the mid pole separating the kidney into three parts and involving the hilum.
There is a small contrast blush at the mid pole posteromedially raising the possibility of active bleeding.
On the delayed scans there is evidence of contrast extravasation from the urinary pelvis consistent with laceration of the collecting system.
Large perinephric haematoma surrounds the kidney and the ureter.
Left renal laceration (AAST Grade IV injury) as described above with active bleeding, and evidence of extravasation from the collecting system.
1 case question available
The kidneys are commonly injured in blunt trauma. Complications such as collecting system injury should always be assessed for with delayed phase imaging and urine leaking from such injuries can be a source of a large volume of intra-abdominal free fluid.