Radiographic evaluation of the renal injuries

Adequate radiologic demonstration of the extent of renal injury following abdominal trauma is an important guide to therapy. In general, renal injuries were classified as minor, major or catastrophic based on a combination of radiological and clinical findings. Diagnostic methods were plain abdominal film, IVP, renal angiography and rapid noninvasive methods, such as ultrasonography and CT. This study was carried out to analyze about each diagnostic modalities including the specific findings of various types and extent of trauma and correlation of these studies for the determination of best diagnostic approach. Case materials were 100 cases of renal injuries during our 5 years experience. The results were as follows: 1. Among 100 patients, men predominated over women; men 82, women 18. About one half (44 cases) of these occurred between the age of 11-30. 2. Nonpenetrating blunt trauma account for 98% of cases. Penetrating injuries were only 3 cases. 3. Associated injuries were noted in 23 cases. 4. Renal injuries were classified into 4 categories. Grade I is contusion (33 cases), II parenchymal injury without pelvocalyceal system involvement (24 cases), III parenchymal injury with pelvocalyceal system involvement (29 cases) and IV injuried involving renal pedicle (15 cases). 5.. IVP is the most common initial diagnostic modality and good for screening of patient, but only 30% of specificity is noted. 6. Renal angiography has many advantage with accurate assesment of variety of lesion and be a good guidance for decision of prognosis and therapy. 7. Ultrasonography and CT are rapid noninvasive study, valuable in assessing the specific type and extent of injury and easily evaluated the entire abdomen. But for the vascular lession, angiography is perfected than ultrasonography or CT. 8. Conservative management was done in 68 cases. Operation were performed in 33 cases and 28 cases of them were major injuries