Presentation
Fall off a motor vehicle, landing on the right side. Right flank tenderness and haematuria.
Patient Data
Contrast-enhanced CT imaging showed a complex right renal injury. The right kidney is partially devascularized, with non-enhancing renal segments and surrounding large perinephric haematoma. This haematoma extends to the retroperitoneal spaces with downward extension through the anterior and posterior pararenal spaces to the pelvic cavity. A filling defect in the proximal part of the right renal vein (in the right hilum) is also noted, suggesting clot formation.
Mild presacral-free fluid is noted.
Due to ureteral injury, contrast extravasation from the proximal part of the right ureter is seen in the lower calyx and renal pelvis during the delayed phase.
No obvious bladder injury is seen.
Hepatic laceration in the 6th and 7th segments of the right liver lobe, approximately 50mm in length with adjacent subcapsular haematoma (AAST grade III liver injury).
Case Discussion
CT is an important imaging modality in the evaluation of intraabdominal and retroperitoneal injuries resulting from blunt abdominal trauma.
Haematuria and hypotension are two critical clinical indicators linked to a higher risk of serious renal injury.
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