Imaging Pearls ❯ Trauma ❯ Kidney
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- “Late or delayed complications of renal trauma develop more than 4 weeks after injury and include hypertension, hydronephrosis, calculus formation, and chronic pyelonephritis.”
Kidney in Danger: CT Findings of Blunt and Penetrating Renal Trauma Alonso RC et al. RadioGraphics 2009; 29:2033–2053 - “Posttraumatic renovascular hypertension may occur anywhere from a few weeks to decades fol- lowing injury, but on average occurs within 34 months. Several mechanisms have been proposed for its development, including renal artery occlusion, stenosis (Goldblatt kidney),
or compression; severe renal contusion; arterio-venous fistula or pseudoaneurysm formation; and chronic contained subcapsular hematoma.”
Kidney in Danger: CT Findings of Blunt and Penetrating Renal Trauma Alonso RC et al. RadioGraphics 2009; 29:2033–2053 - “The term Page kidney refers to hypertension secondary to constrictive ischemic nephropathy caused by large chronic subcapsular hematomas, which exert a mass effect on the adjacent renal parenchyma, indenting or flattening the renal margin.This condition may lead to diminished renal perfusion, fibrosis, and scarring.”
Kidney in Danger: CT Findings of Blunt and Penetrating Renal Trauma Alonso RC et al. RadioGraphics 2009; 29:2033–2053 - “At CT, typical findings include a delayed nephrogram
of the kidney and a surrounding fibrotic band that may be calcified. Because spontaneous resolution of posttraumatic hypertension
has been reported in many studies, conservative and pharmacologic treatment is strongly advised. Surgery, including renal revascularization, partial nephrectomy, or even total nephrectomy, is the second step in the management of posttraumatic hypertension.”
Kidney in Danger: CT Findings of Blunt and Penetrating Renal Trauma Alonso RC et al. RadioGraphics 2009; 29:2033–2053 - “Approximately 10% of all significant blunt ab- dominal traumatic injuries manifest with renal injury, although it is usually minor. Contrast- enhanced CT is the imaging modality of choice in the evaluation and management of renal trauma, since it provides essential anatomic and func- tional information. Renal imaging is indicated in cases of (a) penetrating trauma and hematuria; (b) blunt trauma, shock, and hematuria; and
(c) gross hematuria.”
Kidney in Danger: CT Findings of Blunt and Penetrating Renal Trauma Alonso RC et al. RadioGraphics 2009; 29:2033–2053