- Nearly 50% of renal injuries are treated surgically
- Presence of hematuria is an idication of serioud renal injury
- Absence of hematuria excludes renal injury
- Cortical rim sign on CT scan suggests devascularization
- Hypertension is a known late complication of renal trauma
Notes: About 95% of isolated renal injuries are minor and are managed conservatively. Hematuria is seen in 95% of renal injuries, but absence of hematuria does not exclude renal trauma. Hematuria may be absent in severe renal trauma (25% of renal artery thrombosis may not have hematuria). Hematuria with hypotension is associated with increased risk of significant renal injury; but there is poor correlation between severity of hematuria and severity of renal injury. Complete devascularization shows absent nephrogram or cortical rim nephrogram. Early complications include urinary extravasation and urinoma formation, delayed bleeding, infection of the urinoma, perinephric abscess, sepsis, arteriovenous fistula, pseudoaneurysm and hypertension. Late complications include hydronephrosis, hypertension, calculus formation and chronic pyelonephritis.
References:
1. Fanney DR et al.CT in the diagnosis of renal trauma. RadioGraphics 1990; 10: 29.S201-214
2. Kawashima A et al.Imaging of Renal Trauma: A Comprehensive Review. RadioGraphics 2001; 21: 57
