The reliability of excretory urography as a screening examination for blunt renal trauma

Halsell, Robert D; Vines, Frederick S.; Shatney, Clayton H.; Slepin, M Jeff; Northup, H M; Avara, William T; Doan, Lynnette A

doi:10.1016/s0196-0644(87)80230-5

Cited by 12 publications

(4 citation statements)

References 18 publications

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“…Historically, intravenous pyelography (IVP) was the standard method to image a patient with suspected renal trauma [14,[18][19][20][21][22]. This has been replaced by ultrasound and computed tomography.…”

Section: Imagingmentioning

confidence: 99%

Review of the evidence on the management of blunt renal trauma in pediatric patients

et al. 2009

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Due to the size and location within the pediatric patient, the kidneys are susceptible to injury from blunt trauma. While it is clear that the goal of management of blunt renal trauma in children is renal preservation, the methods of achieving this goal have not been well established in the current literature. Therefore, we have set out to summarize and clarify the current published information on the management strategies for blunt renal trauma in children. While there is extensive literature available, it consists mostly of retrospective series documenting widely varied management styles. The purpose of this review is to display the current information available and delineate the role for future studies that may allow us to develop consistent management strategies of pediatric patients, who have sustained blunt renal trauma, in a safe and cost-effective manner.

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Section: Imagingmentioning

confidence: 99%

Review of the evidence on the management of blunt renal trauma in pediatric patients

et al. 2009

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“…Along with added advantage of providing anatomic and special information as well as functionality, CT is more sensitive and specific than conventional diagnostic tools such as IVP [19,21]. Halsell and Cass et al, in prospective comparisons between CT scan and IVP, found that CT scan to be more sensitive and specific in detecting renal injuries [22,23].…”

Section: Penetrating Renal Traumamentioning

confidence: 99%

Penetrating Injuries to the Spleen and Kidney: an Evolution in Progress

2015

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Optimal management of penetrating abdominal trauma, especially for kidney and splenic injuries, is evolving. Opinions range from aggressive surgical exploration to expectant management. This report addresses the recent advancements in the diagnosis, grading, and management of penetrating injuries to the kidney and spleen. A special focus is provided on the shifting paradigm towards non-operative management. Penetrating renal trauma management has evolved significantly over the past few years. Advancements in diagnostic tools and evolution of injury grading have paved the way for selective non-operative management. Penetrating injuries to the spleen provide a unique management challenge. With the evolution of non-operative management, appropriate patient selection is mandatory. Optimal use of computed tomography scanning and angiography can improve the organ salvage rates; however, hemorrhage control is still the main goal.

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“…An IVU does under-report contusion and extrava~ation~ when compared to CT; however, this difference does not alter treatment. 32 When an IVU is combined with an ultrasound the information gained is frequently equal to that from a CT." There were two cases of minor injuries in this series where there was no function on IVU. Both cases had their IVU performed within 4 h of injury.…”

Section: Investigationsmentioning

confidence: 99%

Paediatric Renal Trauma: Caution With Conservative Management of Major Injuries

Thompson‐Fawcett¹,

Kolbe²

1996

Australian and New Zealand Journal of Surgery

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Background:The kidney is the most frequently injured abdominal organ in children and controversy surrounds some aspects of management. This study looks at the experience of our institution and reviews the literature towards developing an optimal strategy for managing this common childhood injury. Methods: One hundred and forty-two cases of paediatric renal trauma are reported from a catchment population of approximately 240000 children < 14 years of age over a 12 year period. Injuries were classified into four groups: groups 1 and 2 were regarded as minor injuries (85%) and group 3 and 4 injuries were those with extravasation of urine or pedicle injury (15%). Results: The male:female ratio was 2: I with an average age of 8.5 years. Major renal injuries frequently required large amounts of resuscitation fluid. Associated injuries were present in 41% of all cases with an average of two injuries each. With one exception in each case, the development of complications and the need for early surgery were confined to major injuries. There were no long-term complications. The renal loss rate was 2.1 %. Conclusions: Renal injuries can be usefully classified into major or minor by determining whether extravasation of urine or pedicle injury is present. Minor injuries should be managed conservatively. Major injuries causing ongoing haemorrhage require urgent surgery. Other major injuries should be imaged regularly and patients with more severe urinomas benefit from early elective surgery at 2-5 days. In cases where extravasation of urine has not shown clear evidence of settling by 5 days' elective surgery probably results in less morbidity and fewer complications than protracted conservative treatment.

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The reliability of excretory urography as a screening examination for blunt renal trauma

Cited by 12 publications

References 18 publications

Review of the evidence on the management of blunt renal trauma in pediatric patients

Review of the evidence on the management of blunt renal trauma in pediatric patients

Penetrating Injuries to the Spleen and Kidney: an Evolution in Progress

Paediatric Renal Trauma: Caution With Conservative Management of Major Injuries

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