Evaluation of Renal Injuries with Computerized Tomography

Abstract

To document the severity and degree of renal injury multiple studies may be necessary, including excretory urography, nephrotomography and arteriography. Even these extensive studies fail at times to provide sufficient information for treatment of the injury. The need for a more accurate noninvasive modality led to the use of computerized tomography [CT]. CT and excretory urography, and/or nephrotomography was used in 24 patients suspected of having major renal injury. CT clearly separated minor injuries (superficial laceration) from major injuries (deep lacerations or laceration with extravasation). CT demonstrated extravasation of opacified urine not noted on excretory urography in 5 cases. In all cases renal lacerations and perirenal and intrarenal hematomas were defined clearly on CT. CT provided information for proper management in all instances (18 nonsurgical and 6 surgical procedures) and all CT findings were confirmed at operation. CT detected liver, spleen or pancreas injuries in 4 patients. CT provides a highly sensitive and accurate method to evaluate renal trauma, which allows the surgeon to make a confident choice of treatment.