Renal injury - AAST grade IV

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.

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