Journal List > J Korean Radiol Soc > v.19(1) > 1136736

Kang, Chung, Cho, and Hahm: Radiographic evaluation of the renal injuries

Abstract

Adequate radiologic demonstration of the extent of renal injury following abdminal trauma is an importantguide to therapy. In general, renal injuries were classifed as minor, major or catastrophic based on a combinationof radiological and clinical findings. Diagnostic methods were plain abdominal film, IVP, renal angiography andrapid noninvasive methods, such as ultrasonography and CT. This study was carried out to analyze about eachdiagnostic modalities including the specific findings of various types and extent of trauma and correlation ofthese studies for the determination of best daignostic approach. Case materials were 100 cases of renal injuriesduring our 5 years experience. The resuls were as follows; 1. Among 100 patients, men predominated over women; men82, women 18. about one half (44 cases ) of these occured between the age of 11-30. 2. Nonpenetrating blunt traumaaccount for 98% of cases. Penetrating injuries were only 3 cases. 3. Associated injuries were noted in 23 cases.4. Renal injuries were classified into 4 categories. Grade I is contrusion(33 cases), II parenchymal injurywithout pelvocalyceal system involvement (24 cases), III parenchymal injury with pelvocalyceal systeminvolvement(29 cases) and IV injured involving renal pedicle(15 cases). 5. IVP is the most common initialdiagnostic modality and good for screening of patient, but only 30% of specificity is noted. 6. Renal angiographyhas many advantage with accurate assement of variety of lesion and be a good guidence for decision of prognosisand therapy. 7. Ultrasonography and CT are rapid noninvasive study, valuable in assessing the specific type andextent of injury and easily evaluated the entire abdomen. But for the vascular lesion, angiography is preferredthan ultrasonography or CT. 8. Conservative management was done in 68 cases. Operation were performed in 33 casesand 28 cases of them were major injuries.

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