Urinary: Renal Trauma Flashcards

1
Q

Next step: CT demonstrates renal trauma…

A

Get excretory phase imaging to see if there is urine leak

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2
Q

Fractured kidney

A

When a renal laceration connects two cortical surfaces (extending all the way through a kidney)

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3
Q

Shattered kidney

A

A kidney with at least two fractures, resulting in 3 or more renal fragments

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4
Q

Traumatic injury

A

Think renal infarction secondary to segmental arterial injury

Note: This is AAST grade 4 renal trauma.

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5
Q

Traumatic injury

A

Think devascularized kidney due to renal artery injury

Note: This is AAST grade 5 renal trauma.

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6
Q

Traumatic injury

A

Think left renal vein injury or thrombosis

Note: Persistent nephrogram on the left.

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7
Q

Urinary trauma with focal extra-luminal collections of contrast that decrease in attenuation on delayed excretory imaging…

A

Think pseudoaneurysm or AV fistula

Note: Active hemorrhage should get more dense on excretory imaging.

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8
Q

AAST grade 1 renal trauma

A

Subcapsular hematoma without laceration

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9
Q

AAST grade 2 renal trauma

A
  • Mild laceration (<1 cm)
  • Perirenal hematoma confined to the perirenal space (within the perirenal fascia)
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10
Q

AAST grade 3 renal trauma

A
  • Moderate laceration (>1 cm) without renal pelvis injury or urine leak
  • Active hemorrhage confined to the perirenal space
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11
Q

AAST grade 4 renal trauma

A
  • Severe laceration (i.e. fracture: laceration extends to the renal hilum)
  • Segmental infarction due to vascular injury
  • Active hemorrhage extending beyond the perirenal space
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12
Q

AAST grade 5 renal trauma

A
  • Shattered kidney
  • Renal hilum injury (urine leak or main renal artery/vein injury)
  • Devascularized kidney
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13
Q

Which AAST renal trauma grades are generally surgically managed?

A

Grades 4 and 5

Note: Grades 1, 2, and 3 are generally medically managed.

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