BLUNT RENAL TRAUMA IN CHILDREN - HEALING OF RENAL INJURIES AND RECOMMENDATIONS FOR IMAGING FOLLOW-UP

Initial CT grading of renal injury was correlated with the frequency o f complications and the time course of healing in 35 children. All ren al contusions (grade 1, 8) and small parenchymal lacerations (grade 2, 8) healed without complications. All lacerations extending to the col lecting system (grade 3, 9) resulted in mild to severe loss of renal f unction with progressive healing over 4 months. One of four segmental infarcts (grade 4A), and five of six vascular pedicle injuries (grade 4B) resulted in severe loss of renal function. Complications, includin g urinoma (2), sepsis (1), hydronephrosis (1), and persistent hyperten sion (2), were limited to grade 3 and 4 injuries. Our results suggest that mild renal injuries do not require follow-up imaging. Major renal lacerations and vascular pedicle injuries, however, often result in l oss of renal function and should be followed up closely due to the ris k of delayed complications. Follow-up examinations should continue for 3-4 months until healing is documented.