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Renal Injury
Michael R. Aquino, MD, MHSc
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KEY FACTS

  • Imaging

    • Pathology

      • Clinical Issues

        TERMINOLOGY

        • Definitions

          • Trauma to parenchyma &/or collecting system of kidney

        IMAGING

        • General Features

          • Radiographic Findings

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Angiographic Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          • Reporting Tips

                                            Selected References

                                            1. Bowen DK et al: Does contrast-enhanced ultrasound have a role in evaluation and management of pediatric renal trauma? A preliminary experience. J Pediatr Surg. 55(12):2740-5, 2020
                                            2. Redmond EJ et al: Contemporary management of pediatric high grade renal trauma: 10 year experience at a level 1 trauma centre. J Pediatr Urol. 16(5):656.e1-5, 2020
                                            3. Coccolini F et al: Kidney and uro-trauma: WSES-AAST guidelines. World J Emerg Surg. 14:54, 2019
                                            4. Gates RL et al: Non-operative management of solid organ injuries in children: an American Pediatric Surgical Association Outcomes and Evidence Based Practice Committee systematic review. J Pediatr Surg. 54(8):1519-26, 2019
                                            5. Hagedorn JC et al: Pediatric blunt renal trauma practice management guidelines: collaboration between the Eastern Association for the Surgery of Trauma and the Pediatric Trauma Society. J Trauma Acute Care Surg. 86(5):916-25, 2019
                                            6. Armstrong LB et al: Pediatric renal injury: which injury grades warrant close follow-up. Pediatr Surg Int. 34(11):1183-7, 2018
                                            7. Fuchs ME et al: Is delayed phase computed tomography imaging necessary after blunt renal trauma in children? Urology. 113:187-91, 2018
                                            8. Kozar RA et al: Organ injury scaling 2018 update: spleen, liver, and kidney. J Trauma Acute Care Surg. 85(6):1119-22, 2018
                                            9. Bryk DJ et al: Guideline of guidelines: a review of urological trauma guidelines. BJU Int. 117(2):226-34, 2016
                                            10. Chiron P et al: Grade IV renal trauma management. A revision of the AAST renal injury grading scale is mandatory. Eur J Trauma Emerg Surg. 42(2):237-41, 2016
                                            11. Dangle PP et al: Evolving mechanisms of injury and management of pediatric blunt renal trauma--20 years of experience. Urology. 90:159-63, 2016
                                            12. LeeVan E et al: Management of pediatric blunt renal trauma: a systematic review. J Trauma Acute Care Surg. 80(3):519-28, 2016
                                            13. Dahlstrom K et al: Blunt renal trauma in children with pre-existing renal abnormalities. Pediatr Radiol. 45(1):118-23; quiz 115-7, 2015
                                            14. Grimsby GM et al: Demographics of pediatric renal trauma. J Urol. 192(5):1498-502, 2014
                                            15. Morey AF et al: Urotrauma: AUA guideline. J Urol. 192(2):327-35, 2014
                                            16. Reese JN et al: Timing and predictors for urinary drainage in children with expectantly managed grade IV renal trauma. J Urol. 192(2):512-7, 2014
                                            17. Sheybani EF et al: Pediatric nonaccidental abdominal trauma: what the radiologist should know. Radiographics. 34(1):139-53, 2014
                                            18. Bartley JM et al: Computed tomography findings in patients with pediatric blunt renal trauma in whom expectant (nonoperative) management failed. Urology. 80(6):1338-43, 2012
                                            19. Alonso RC et al: Kidney in danger: CT findings of blunt and penetrating renal trauma. Radiographics. 29(7):2033-53, 2009
                                            20. Catalano O et al: CEUS in abdominal trauma: multi-center study. Abdom Imaging. 34(2):225-34, 2009
                                            21. Cannon GM Jr et al: Computerized tomography findings in pediatric renal trauma--indications for early intervention?. J Urol. 179(4):1529-32; discussion 1532-3, 2008
                                            22. Körner M et al: Current role of emergency US in patients with major trauma. Radiographics. 28(1):225-42, 2008
                                            23. Malcolm JB et al: Nonoperative management of blunt renal trauma: is routine early follow-up imaging necessary? BMC Urol. 8:11, 2008
                                            24. Kawashima A et al: Imaging of renal trauma: a comprehensive review. Radiographics. 21(3):557-74, 2001
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Imaging

                                              • Pathology

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Definitions

                                                    • Trauma to parenchyma &/or collecting system of kidney

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            • Angiographic Findings

                                                              • Nuclear Medicine Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Staging, Grading, & Classification

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Demographics

                                                                            • Natural History & Prognosis

                                                                              • Treatment

                                                                                DIAGNOSTIC CHECKLIST

                                                                                • Consider

                                                                                  • Image Interpretation Pearls

                                                                                    • Reporting Tips

                                                                                      Selected References

                                                                                      1. Bowen DK et al: Does contrast-enhanced ultrasound have a role in evaluation and management of pediatric renal trauma? A preliminary experience. J Pediatr Surg. 55(12):2740-5, 2020
                                                                                      2. Redmond EJ et al: Contemporary management of pediatric high grade renal trauma: 10 year experience at a level 1 trauma centre. J Pediatr Urol. 16(5):656.e1-5, 2020
                                                                                      3. Coccolini F et al: Kidney and uro-trauma: WSES-AAST guidelines. World J Emerg Surg. 14:54, 2019
                                                                                      4. Gates RL et al: Non-operative management of solid organ injuries in children: an American Pediatric Surgical Association Outcomes and Evidence Based Practice Committee systematic review. J Pediatr Surg. 54(8):1519-26, 2019
                                                                                      5. Hagedorn JC et al: Pediatric blunt renal trauma practice management guidelines: collaboration between the Eastern Association for the Surgery of Trauma and the Pediatric Trauma Society. J Trauma Acute Care Surg. 86(5):916-25, 2019
                                                                                      6. Armstrong LB et al: Pediatric renal injury: which injury grades warrant close follow-up. Pediatr Surg Int. 34(11):1183-7, 2018
                                                                                      7. Fuchs ME et al: Is delayed phase computed tomography imaging necessary after blunt renal trauma in children? Urology. 113:187-91, 2018
                                                                                      8. Kozar RA et al: Organ injury scaling 2018 update: spleen, liver, and kidney. J Trauma Acute Care Surg. 85(6):1119-22, 2018
                                                                                      9. Bryk DJ et al: Guideline of guidelines: a review of urological trauma guidelines. BJU Int. 117(2):226-34, 2016
                                                                                      10. Chiron P et al: Grade IV renal trauma management. A revision of the AAST renal injury grading scale is mandatory. Eur J Trauma Emerg Surg. 42(2):237-41, 2016
                                                                                      11. Dangle PP et al: Evolving mechanisms of injury and management of pediatric blunt renal trauma--20 years of experience. Urology. 90:159-63, 2016
                                                                                      12. LeeVan E et al: Management of pediatric blunt renal trauma: a systematic review. J Trauma Acute Care Surg. 80(3):519-28, 2016
                                                                                      13. Dahlstrom K et al: Blunt renal trauma in children with pre-existing renal abnormalities. Pediatr Radiol. 45(1):118-23; quiz 115-7, 2015
                                                                                      14. Grimsby GM et al: Demographics of pediatric renal trauma. J Urol. 192(5):1498-502, 2014
                                                                                      15. Morey AF et al: Urotrauma: AUA guideline. J Urol. 192(2):327-35, 2014
                                                                                      16. Reese JN et al: Timing and predictors for urinary drainage in children with expectantly managed grade IV renal trauma. J Urol. 192(2):512-7, 2014
                                                                                      17. Sheybani EF et al: Pediatric nonaccidental abdominal trauma: what the radiologist should know. Radiographics. 34(1):139-53, 2014
                                                                                      18. Bartley JM et al: Computed tomography findings in patients with pediatric blunt renal trauma in whom expectant (nonoperative) management failed. Urology. 80(6):1338-43, 2012
                                                                                      19. Alonso RC et al: Kidney in danger: CT findings of blunt and penetrating renal trauma. Radiographics. 29(7):2033-53, 2009
                                                                                      20. Catalano O et al: CEUS in abdominal trauma: multi-center study. Abdom Imaging. 34(2):225-34, 2009
                                                                                      21. Cannon GM Jr et al: Computerized tomography findings in pediatric renal trauma--indications for early intervention?. J Urol. 179(4):1529-32; discussion 1532-3, 2008
                                                                                      22. Körner M et al: Current role of emergency US in patients with major trauma. Radiographics. 28(1):225-42, 2008
                                                                                      23. Malcolm JB et al: Nonoperative management of blunt renal trauma: is routine early follow-up imaging necessary? BMC Urol. 8:11, 2008
                                                                                      24. Kawashima A et al: Imaging of renal trauma: a comprehensive review. Radiographics. 21(3):557-74, 2001