URINARY Section 8: Renal Trauma

Question 1

How is renal injury graded?

Answer 1

based on the presence of

Hematoma - laceration - involvement of vein, artery or UPJ obstruction

Question 2

“next step” in the setting of renal trauma =

Answer 2

Delayed imaging

Question 3

A laceration, which extends the full depth of the renal parenchyma.

Answer 3

Fractured kidney

“must connect two cortical surfaces”

Question 4

Answer 4

Renal fracture

Question 5

Answer 5

Shattered kidney

A kidney with 3 or more fragments - this is the most severe form of renal fracture.

Question 6

Answer 6

Segmental Artery Injury

“Wedge-Shaped Perfusion Abnormality”

Question 7

Answer 7

Devascularized kidney

“Diffuse nonperfusion”

Question 8

Answer 8

Renal vein injury/thrombosis

“Persistent Nephrogram”

Question 9

Indication for trauma protocol

Answer 9

Any tauma
Gross hematuria
Low BP (SBP < 90)
Lower rib fractures
flank bruising

Question 10

Standar trauma protocol

Answer 10

arterial phase (aorta timed) through the chest

portal venous phase (~70 seconds) through the abdomen and pelvis

If a ureteral injury or bladder injury is suspected excretory phase “delays” should be obtained (5-15 minutes)

Question 11

Grade I trauma

Answer 11

Question 12

Grade II Trauma

Answer 12

Question 13

Grade III Trauma

Answer 13

Question 14

Grade IV

Answer 14

Question 15

Grave V

Answer 15