Renal trauma - Revision history

Rossdonaldson1: /* Differential Diagnosis */

2023-05-03T17:10:35Z

Differential Diagnosis

2022-08-03T19:38:09Z

Differential Diagnosis

2021-03-17T21:04:10Z

Evaluation

← Older revision		Revision as of 21:04, 17 March 2021
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	==Evaluation==		==Evaluation==
	~~[[Abdotrauma.png\|thumb\|Abdominal trauma resulting in a right kidney contusion (open arrow) and blood surrounding the kidney (closed arrow) as seen on CT.]]~~
	[[File:PMC5265200 13244 2016 536 Fig6 HTML.png\|thumb\|Delayed-phase CT shows fluid filling the right perinephric space in a patient following blunt trauma. The kidney has been lacerated (short arrow), and urinary contrast extravasation is shown posteriorly (long arrow)]]		[[File:PMC5265200 13244 2016 536 Fig6 HTML.png\|thumb\|Delayed-phase CT shows fluid filling the right perinephric space in a patient following blunt trauma. The kidney has been lacerated (short arrow), and urinary contrast extravasation is shown posteriorly (long arrow)]]
	===Workup===		===Workup===

2021-03-17T21:03:17Z

Evaluation

← Older revision		Revision as of 21:03, 17 March 2021
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	==Evaluation==		==Evaluation==
			[[Abdotrauma.png\|thumb\|Abdominal trauma resulting in a right kidney contusion (open arrow) and blood surrounding the kidney (closed arrow) as seen on CT.]]
	[[File:PMC5265200 13244 2016 536 Fig6 HTML.png\|thumb\|Delayed-phase CT shows fluid filling the right perinephric space in a patient following blunt trauma. The kidney has been lacerated (short arrow), and urinary contrast extravasation is shown posteriorly (long arrow)]]		[[File:PMC5265200 13244 2016 536 Fig6 HTML.png\|thumb\|Delayed-phase CT shows fluid filling the right perinephric space in a patient following blunt trauma. The kidney has been lacerated (short arrow), and urinary contrast extravasation is shown posteriorly (long arrow)]]
	===Workup===		===Workup===

2021-02-27T17:39:05Z

Diagnosis

@@ Line 20: / Line 20: @@
 ===Diagnosis===
-====AAST Grading System for renal injuries====
+====AAST Renal Injury Scale====
-*Non-operative management<ref>Shariat, S. F., Roehrborn, C. G., Karakiewicz, P. I., Dhami, G. and Stage, K. H. (2007) ‘Evidence-Based Validation of the Predictive Value of the American Association for the Surgery of Trauma Kidney Injury Scale’, The Journal of Trauma: Injury, Infection, and Critical Care, 62(4), pp. 933–939.</ref>
+{| {{table}}
-**'''Grade I:''' Cortex contusion
+| align="center" style="background:#f0f0f0;"|'''Grade'''
-**'''Grade II:''' Cortex laceration
+| align="center" style="background:#f0f0f0;"|'''Description'''
-*Possible operative management
+| align="center" style="background:#f0f0f0;"|'''Image'''
-**'''Grade III:''' Corticomedullary junction laceration
+| align="center" style="background:#f0f0f0;"|'''CT Example'''
-**'''Grade IV:''' Collecting system laceration
+|-
-*Operative management
+| '''I'''
-**'''Grade V:''' Shattered kidney, thrombosis of renal artery, avulsion of hilum
+||
 ==Management==

2021-02-24T20:39:43Z

2021-02-16T06:35:51Z

Management

← Older revision		Revision as of 06:35, 16 February 2021
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	==Management==		==Management==
	*Based on grade of injury (above)		*Based on grade of injury (above)
			*Grade I and II
			**observation, vital signs monitoring, bed rest, antibiotic prophylaxis, monitor hematuria
	*Prophylactic IV [[antibiotics]] for grade IV, V injuries (first generation [[cephalosporin]], [[ciprofloxacin]], or [[ampicillin]] and [[gentamicin]])		*Prophylactic IV [[antibiotics]] for grade IV, V injuries (first generation [[cephalosporin]], [[ciprofloxacin]], or [[ampicillin]] and [[gentamicin]])
	*Absolute indications for operative renal exploration and intervention:		*Absolute indications for operative renal exploration and intervention:

2020-05-02T11:23:53Z

Background

← Older revision		Revision as of 11:23, 2 May 2020
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	==Background==		==Background==
			[[File:Urinary system.png\|thumb\|'''(1) Human urinary system:''' (2) kidney; (3) renal pelvis; (4) ureter; (5) urinary bladder (6) urethra. <Br>'''Additional structures:''' (7) adrenal gland; (8) renal artery and vein; (9) inferior vena cava; (10) abdominal aorta; (11) common iliac artery and vein; (12) liver; (13) large intestine; (14) pelvis.]]
	[[File:Blausen 0592 KidneyAnatomy 01.png\|thumb\|Renal anatomy.]]		[[File:Blausen 0592 KidneyAnatomy 01.png\|thumb\|Renal anatomy.]]
	[[File:PMC5265200 13244 2016 536 Fig1 HTML.png\|thumb\|Perinephric space with exaggerated pararenal space to show retroperitoneal structures. Perinephric bridging septa are seen between the left kidney and the adjacent renal fascia.]]		[[File:PMC5265200 13244 2016 536 Fig1 HTML.png\|thumb\|Perinephric space with exaggerated pararenal space to show retroperitoneal structures. Perinephric bridging septa are seen between the left kidney and the adjacent renal fascia.]]

2020-05-02T11:23:36Z

Workup

← Older revision		Revision as of 11:23, 2 May 2020
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	==Evaluation==		==Evaluation==
	[[File:PMC5265200 13244 2016 536 Fig6 HTML.png\|thumb\|Delayed-phase CT shows fluid filling the right perinephric space in a patient following blunt trauma. The kidney has been lacerated (short arrow), and urinary contrast extravasation is shown posteriorly (long arrow)]]		[[File:PMC5265200 13244 2016 536 Fig6 HTML.png\|thumb\|Delayed-phase CT shows fluid filling the right perinephric space in a patient following blunt trauma. The kidney has been lacerated (short arrow), and urinary contrast extravasation is shown posteriorly (long arrow)]]
	==Workup==		===Workup===
	*CT with contrast		*CT with contrast

2020-05-02T11:23:05Z

Background

← Older revision		Revision as of 11:23, 2 May 2020
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	==Background==		==Background==
			[[File:Blausen 0592 KidneyAnatomy 01.png\|thumb\|Renal anatomy.]]
			[[File:PMC5265200 13244 2016 536 Fig1 HTML.png\|thumb\|Perinephric space with exaggerated pararenal space to show retroperitoneal structures. Perinephric bridging septa are seen between the left kidney and the adjacent renal fascia.]]
	*Approximately 10% of blunt injuries include renal trauma		*Approximately 10% of blunt injuries include renal trauma
	*Blunt mechanism 9x more common than penetrating<ref>Miller, K. S. and McAninch, J. W. (1995) ‘Radiographic Assessment of Renal Trauma’, The Journal of Urology, pp. 352–355. </ref>		*Blunt mechanism 9x more common than penetrating<ref>Miller, K. S. and McAninch, J. W. (1995) ‘Radiographic Assessment of Renal Trauma’, The Journal of Urology, pp. 352–355. </ref>