LIMITATIONS OF ROUTINE SPIRAL COMPUTERIZED TOMOGRAPHY IN THE EVALUATION OF BLUNT RENAL TRAUMA

Abstract

No AccessJournal of UrologyClinical Urology: Original Articles1 Dec 1998LIMITATIONS OF ROUTINE SPIRAL COMPUTERIZED TOMOGRAPHY IN THE EVALUATION OF BLUNT RENAL TRAUMA SCOTT L. BROWN, DANIEL M. HOFFMAN, and J. PATRICK SPIRNAK SCOTT L. BROWNSCOTT L. BROWN , DANIEL M. HOFFMANDANIEL M. HOFFMAN , and J. PATRICK SPIRNAKJ. PATRICK SPIRNAK View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)62218-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We have observed that injury to the renal collecting system may be missed during routine abdominal spiral computerized tomography (CT) for trauma. A definitive protocol for spiral CT has been established to identify all cases of renal collecting system injury. Materials and Methods: A retrospective review of 35 consecutive cases of blunt renal trauma evaluated with spiral CT between 1994 and 1997 at our Level I trauma center was performed. Each patient received 100 cc intravenous contrast at 2 cc per second. There was a 60-second delay after the start of contrast infusion before scanning was initiated. Results: Of the 35 cases 3 (8.6%) injuries to the renal collecting system were detected on delayed scans obtained after the initial CT failed to demonstrate contrast extravasation. Therefore, at our institution we have modified the protocol for spiral CT for abdominal trauma by repeating scans of the kidneys after the initial scans are completed. Conclusions: Injury to the renal collecting system may be missed during routine spiral CT, thereby incorrectly under staging renal trauma. In all cases of suspected blunt renal trauma evaluated with spiral CT repeat scans of the kidneys should be performed. References 1 : Computed tomography scanning with simultaneous patient translation. Med. Phys.1990; 17: 967. Google Scholar 2 : Spiral volumetric CT with single-breath-hold technique, continuous transport, and continuous scanner rotation. Radiology1990; 176: 181. Google Scholar 3 : Lung: Spiral volumetric CT with single-breath-hold technique. Radiology1990; 176: 864. Google Scholar 4 : Helical (spiral) CT of the retroperitoneum. Radiol. Clin. N. Amer.1995; 33: 903. Google Scholar 5 : Computerized tomographic staging of renal trauma: 85 consecutive cases. J. Urol.1986; 136: 561. Link, Google Scholar 6 : Renal reconstruction after injury. J. Urol.1991; 145: 932. Link, Google Scholar 7 : Indications for radiographic assessment in suspected renal trauma. Urol. Clin. N. Amer.1989; 16: 187. Google Scholar 8 : Radiographic evaluation of adult patients with blunt renal trauma. J. Urol.1992; 148: 266. Link, Google Scholar 9 : Radiographic evaluation of renal trauma: evaluation of 1,103 consecutive patients. Brit. J. Urol.1994; 73: 352. Google Scholar 10 : Organ injury scaling: spleen, liver, and kidney. J. Trauma1989; 29: 1664. Google Scholar 11 : Ureteropelvic junction disruption secondary to blunt trauma: excretory phase imaging (delayed films) should help prevent a missed diagnosis. J. Urol.1998; 159: 67. Link, Google Scholar 12 : The use of ureteral stents in the management of major renal trauma with urinary extravasation: is there a role?. J. Endourol.1998; . in press. Google Scholar From the Department of Urology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byHAAS C, BROWN S and SPIRNAK J (2018) LIMITATIONS OF ROUTINE SPIRAL COMPUTERIZED TOMOGRAPHY IN THE EVALUATION OF BLADDER TRAUMAJournal of Urology, VOL. 162, NO. 1, (51-52), Online publication date: 1-Jul-1999. Volume 160Issue 6 Part 1December 1998Page: 1979-1981 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information SCOTT L. BROWN More articles by this author DANIEL M. HOFFMAN More articles by this author J. PATRICK SPIRNAK More articles by this author Expand All Advertisement PDF downloadLoading ...