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Pediatric Radiology

, Volume 45, Issue 1, pp 118–123 | Cite as

Blunt renal trauma in children with pre-existing renal abnormalities

  • Kelly Dahlstrom
  • Brian DunoskiEmail author
  • Jeffrey Michael Zerin
Pictorial Essay

Abstract

The kidneys are the most commonly injured genitourinary organ in children following blunt abdominal trauma. Though the retroperitoneal location affords the kidneys some protection from the forces experienced in blunt abdominal trauma, the kidneys are at greater risk of injury when a disease process exposes them from their normal shielded location. In such cases, the injuries may appear to be disproportionate in relation to the severity of the trauma history, confusing the imaging findings. Recognition of both the underlying disease process as well as the manifestations of acute trauma is important; therefore, we present a pictorial essay of traumatized kidneys in children with pre-existing renal abnormalities.

Keywords

Renal trauma Kidney Computed tomography Genitourinary tract Renal tumor Congenital anomaly Children 

Notes

Conflicts of interest

None

References

  1. 1.
    Brown SL, Elder JS, Spirnak JP (1998) Are pediatric patients more susceptible to major renal injury from blunt trauma? A comparative study. J Urol 160:138–140PubMedCrossRefGoogle Scholar
  2. 2.
    Nguyen MM, Das S (2002) Pediatric renal trauma. Urology 59:762–767PubMedCrossRefGoogle Scholar
  3. 3.
    Chopra P, St-Vil D, Yazbeck S (2002) Blunt renal trauma—blessing in disguise? J Pediatr Surg 37:779–782PubMedCrossRefGoogle Scholar
  4. 4.
    Bixby SD, Callahan MJ, Taylor GA (2008) Imaging in pediatric blunt abdominal trauma. Sem Roentgen 43:72–82CrossRefGoogle Scholar
  5. 5.
    Onen A, Kaya M, Cigdem MK et al (2002) Blunt renal trauma in children with previously undiagnosed pre-existing renal lesions and guidelines for effective initial management of kidney injury. BJU Int 89:936–941PubMedCrossRefGoogle Scholar
  6. 6.
    Schmidlin FR, Iselin CE, Naimi A et al (1998) The higher injury risk of abnormal kidneys in blunt renal trauma. Scand J Urol Nephrol 32:388–392PubMedCrossRefGoogle Scholar
  7. 7.
    Stein JP, Kaji DM, Eastham J et al (1994) Blunt renal trauma in the pediatric population: indications for radiographic evaluation. Urology 44:406–410PubMedCrossRefGoogle Scholar
  8. 8.
    Broghammer JA, Langenburg SE, Smith SJ et al (2006) Pediatric blunt renal trauma: its conservative management and patterns of associated injuries. Urology 67:823–827PubMedCrossRefGoogle Scholar
  9. 9.
    Esho JO, Ireland GW, Cass AS (1973) Renal trauma and preexisting lesions of kidney. Urology 1:134–135PubMedCrossRefGoogle Scholar
  10. 10.
    Lee YJ, Oh SN, Rha SE et al (2007) Renal trauma. Radiol Clin North Am 45:581–592PubMedCrossRefGoogle Scholar
  11. 11.
    McAleer IM, Kaplan GW, LoSasso BE (2002) Congenital urinary tract anomalies in pediatric renal trauma patients. J Urol 168:1808–1810PubMedCrossRefGoogle Scholar
  12. 12.
    Reda EF, Lebowitz RL (1986) Traumatic ureteropelvic disruption in the child. Pediatr Radiol 16:164–166PubMedCrossRefGoogle Scholar
  13. 13.
    Brown SL, Haas C, Dinchman KH et al (2001) Radiologic evaluation of pediatric blunt renal trauma in patients with microscopic hematuria. World J Surg 25:1557–1560PubMedCrossRefGoogle Scholar
  14. 14.
    Fitzgerald CL, Tran P, Burnell J et al (2011) Instituting a conservative management protocol for pediatric blunt renal trauma: evaluation of a prospectively maintained patient registry. J Urol 185:1058–1064PubMedCrossRefGoogle Scholar
  15. 15.
    Heyns CF (2004) Renal trauma: indications for imaging and surgical exploration. BJU Int 93:1165–1170PubMedCrossRefGoogle Scholar
  16. 16.
    Morey AF, Bruce JE, McAninch JW (1996) Efficacy of radiographic imaging in pediatric blunt renal trauma. J Urol 156:2014–2018PubMedCrossRefGoogle Scholar
  17. 17.
    Damasio MB, Darge K, Riccabona M (2013) Multi-detector CT in the paediatric urinary tract. Eur J Radiol 82:1118–1125PubMedCrossRefGoogle Scholar
  18. 18.
    Dinkel HP, Moll R, Fieger M et al (1999) Opacification of the urinary tract in portal venous spiral CT without delayed scans. Eur J Radiol 9:1579–1585CrossRefGoogle Scholar
  19. 19.
    Henderson CG, Sedberry-Ross S, Pickard R et al (2007) Management of high grade renal trauma: 20-year experience at a pediatric Level I trauma center. J Urol 178:246–250PubMedCrossRefGoogle Scholar
  20. 20.
    Dillman JR, Bates DG (2013) Congenital and neonatal abnormalities. In: Caffey’s pediatric diagnostic imaging, 12th edn. Elsevier, Philadelphia, pp 1195–1208Google Scholar
  21. 21.
    Lonergan GJ, Rice RR, Suarez ES (2000) Autosomal recessive polycystic kidney disease: radiologic-pathologic correlation. Radiographics 20:837–855PubMedCrossRefGoogle Scholar
  22. 22.
    Bisceglia M, Galliana CA, Senger C et al (2006) Renal cystic diseases: a review. Adv Anat Pathol 13:26–56PubMedCrossRefGoogle Scholar
  23. 23.
    Avni FE, Guissard G, Hall M et al (2002) Hereditary polycystic kidney diseases in children: changing sonographic patterns through childhood. Pediatr Radiol 32:169–174PubMedCrossRefGoogle Scholar
  24. 24.
    Bedard MP, Wildman S, Dillman JR (2013) Embryology, anatomy, and variants of the genitourinary tract. In: Caffey’s pediatric diagnostic imaging, 12th edn. Elsevier, Philadelphia, pp 1163–1173Google Scholar
  25. 25.
    Lowe LH, Isuani BH, Heller RM et al (2000) Pediatric renal masses: Wilms tumor and beyond. Radiographics 20:1585–1603PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Kelly Dahlstrom
    • 1
  • Brian Dunoski
    • 2
    Email author
  • Jeffrey Michael Zerin
    • 3
  1. 1.Kansas City University of Medicine and BiosciencesKansas CityUSA
  2. 2.Pediatric Radiology DepartmentChildren’s Mercy Hospital and ClinicsKansas CityUSA
  3. 3.Division of Pediatric Imaging, Children’s Hospital of Michigan, Detroit Medical CenterWayne State University School of MedicineDetroitUSA

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