Renal Trauma

  • Etiology: blunt abdominal trauma
  • Imaging: spectrum is minor – contusion and laceration (85%) / major – laceration through collecting system (10%) / catastrophic – vascular disruption or laceration with extravasation of contrast (5%), hematoma can extend into subscapsular / perirenal / anterior pararenal / peritoneal spaces, extravasation of urine with urinoma on delayed images

Cases of Renal Trauma

CT of adrenal hemorrhage
Axial CT with contrast of the abdomen show a low density fluid collection in the right adrenal gland and low density in the posterior aspect of the right kidney.
CT of renal trauma / renal laceration
Axial CT with contrast of the abdomen shows areas of low density in the anterior and lateral aspects of the left kidney with associated left perirenal and pararenal high density fluid collections.
CT of renal trauma / renal laceration and ureteral trauma / ureteral transection and splenic trauma / splenic laceration
Axial and coronal CT with contrast of the abdomen immediate phase (above) shows low density in the superior and inferior poles of the left kidney and fluid in the left perirenal and pararenal spaces. There is also a large area of low density in the spleen. Delayed phase CT images (below) show extravasation of urine out of the ureter into the left pararenal space.