Renal injury - AAST grade IV

Case contributed by Dr Barbara Turi

Presentation

Haematuria, hypotension with arterial pressure less than 90 mmHg, shock and clinical suspicion of multiorgan involvement.

Patient Data

Gender: Male
CT

CT multiphasic study protocol in patient with abdominal trauma  for suspected renal trauma includes an unenhanced scan without contrast, an initial arterial phase with a scanning delay of 20-30 s to identify vascular damage, followed by a nephrographic phase at 70-80 s to identify parenchymal lesions and a late phase at 3 minutes to detect lesions of the urinary tract.

Cortical-medullary lacerations extending to the collecting system. Injury to the calyceal system with postcontrast CT images of urinary extravasation in the perirenal space. 

Case Discussion

CT study allows staging of renal injuries, with the identification of type, location and extent of parenchymal damage and presence of active bleeding or urinary extravasation. 

We used a multiphasic study protocol, based on whole-body CT for trauma technique.

CT multiphasic study protocol in patients with suspected renal injury after an abdominal trauma includes an unenhanced scan without contrast, an initial arterial phase with a scanning delay of 20-30 s to identify vascular damage, followed by a nephrographic phase at 70-80 s to identify parenchymal lesions and a late phase at 3 minutes to detect lesions of the urinary tract. In addition, CT enables evaluation of contralateral kidney function and detection of concomitant involvement of other abdominal organs.

PlayAdd to Share

Case information

rID: 24601
Published: 30th Aug 2013
Last edited: 22nd Feb 2019
System: Urogenital
Tag: crop
Inclusion in quiz mode: Excluded

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.