CT findings in blunt renal trauma

Computed tomography (CT) can provide essential anatomic and physiologic inf ormation required to determine management of intraabdominal and retroperito neal injuries sustained during blunt abdominal trauma. It can help in evalu ation of the type and severity of parenchymal injury, the extent of periren al hemorrhage and parenchymal devascularization, and the presence of urinar y extravasation. CT can help confirm the presence of major injuries to the vascular pedicle and depict occult renal pathologic conditions. Principal i ndications for the use of CT in the evaluation of blunt renal trauma includ e (a) the presence of gross hematuria, (b) microscopic hematuria associated with shock (systolic blood pressure < 90 mm Hg), and (c) microscopic hemat uria associated with a positive result of diagnostic peritoneal lavage. The majority of renal injuries sustained during blunt abdominal trauma are con tusions and minor parenchymal lacerations amenable to nonoperative manageme nt. Deep parenchymal lacerations, urinary extravasation, and mild to modera te degrees of parenchymal devascularization may also be treated conservativ ely. Radiologists should look for coexisting renal lesions such as tumors a nd traumatic false aneurysms that may alter management.