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Renal Injuries

  • Silvia Lucarini
  • Alessandro Castellani
  • Elena Bertelli
  • Monica Marina Lanzetta
  • Simone Agostini
  • Margherita Trinci
  • Vittorio Miele
Chapter

Abstract

The kidney is the most frequently injured organ in genitourinary trauma, mostly in case of blunt trauma.

In the past decades, the management of these injuries has radically changed toward a more conservative approach, also thanks to a more precise diagnostic imaging in describing not only the presence of a lesion but also the negative prognostic factors, with an important increase in the use of interventional techniques.

Ultrasound (US) can show a renal injury and is useful to evaluate the presence of hemoperitoneum but is limited in the detection of extraperitoneal fluid. With the use of contrast-enhanced ultrasound (CEUS), the possibility of detecting renal parenchymal lesions and perirenal hematoma is greatly increased, but there is no opportunity to evaluate the urinary tract. Multidetector computed tomography (MDCT) is the modality of choice to evaluate renal injuries in polytrauma stable trauma patients.

Several classification systems have been raised, but the most used ones are the American Association for the Surgery of Trauma (AAST) injury scale, based on surgical findings, and the Federle classification, based on imaging findings. Based on these classification systems, the radiologist gives important information regarding the different injury types, leading to the correct choice of the therapeutical approach to kidney injury.

Keywords

Trauma Trauma imaging Renal trauma Multidetector computed tomography (MDCT) Contrast-enhanced ultrasound (CEUS) Ultrasound (US) Classification Management 

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Silvia Lucarini
    • 1
  • Alessandro Castellani
    • 1
  • Elena Bertelli
    • 1
  • Monica Marina Lanzetta
    • 1
  • Simone Agostini
    • 1
  • Margherita Trinci
    • 2
  • Vittorio Miele
    • 1
  1. 1.Department of RadiologyCareggi University HospitalFlorenceItaly
  2. 2.Department of Emergency RadiologyS. Camillo HospitalRomeItaly

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