Blunt injury of the abdomen: a plea for CT

A 3-year-old boy was brought to the emergency unit 1 h following a decelera tion injury. On clinical examination there were no signs of injury and US s howed only free intraperitoneal fluid. The following morning, contrast-enha nced CT showed the right kidney did not enhance and delayed scans showed co ntrast medium in the renal vein. This is an indirect sign of post-traumatic renal artery occlusion. Failure to recognise this sign may have disastrous consequences in a patient with solitary kidney or bilateral renal artery o cclusion. Contrast-enhanced CT scan remains the most widely available inves tigation for accurate staging of blunt renal trauma.