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Abstract
Although The kidney is protected from damage by the surrounding ribs, muscles and fat, renal trauma is the most common urologic trauma that occurs in 8-10% of patients with significant blunt or penetrating abdominal trauma.
Mortality and morbidity rates for renal injuries vary with the severity of renal injury, the degree of injury to other organs, and the treatment plan utilized .
So, Renal trauma imaging by a skilled radiologist is increasingly important.
radiologists can improve the long-term outcome of patients by accurately distinguishing patients that can be optimally managed conservatively from those who need surgery.
This study was conducted on 25 patients with renal trauma; 19 males and 6 females with age ranging between 3 and 53 years. All patients underwent complete history taking and full clinical examination then U/S & CT examination of the abdomen pelvis were done for all patients.
Different types of motor vehicle accidents represented the most common cause of renal trauma that reported in 12 patient (48 %) and males aged between 20 to 40 years old formed the main bulk as their number reached 13 (48 %) of our patients.
The most common presentation was gross hematuria that was recorded in 23 patient (92 %) while shock was the second one that recorded in 17 patient (68%).
Associated multi-organ injuries in renal trauma patients were reported in 19 (76%)of our patients , while only 6 (24 %) were reported as isolated renal injury.
The final diagnosis of our renal trauma patients revealed that grade 1 renal trauma was the most frequent renal trauma that was recorded in 7 of our patients, while grade 3 renal trauma is the least frequent one that was recorded in 2 patients only.
Ultrasound examination of our patients revealed high sensitivity in detection of positive renal injury findings that recorded in 20 cases (80 %) , regardless the grade of trauma , and its false negative results were recorded in 5 cases (20%). While the sensitivity of ultrasound in assessment of the grade of renal trauma was recorded in 13 patient ( 52 % ) that means that ultrasound could be used as primary screening techniue that if positive ,or negative but clinical suspicion still presents, it needs further confirmation by another modality.
On the other hand, CT examination of our patients revealed that it wasn’t only high sensitive in detection of positive renal injury findings in 24 patient (96%), but it also was high sensitive in grading renal injury that recorded in 22 patient(88%) that deserves being the imaging modality of choice in evaluation of renal trauma.