Renal trauma: imaging evaluation and implications for clinical management.

Severe renal injuries are usually associated with multisystem injuries, may require interventional radiology to control hemorrhage and improve the chances for renal salvage, and are more likely to fail nonoperative management. However, most renal injuries are mild in severity and successfully managed conservatively. The AAST classification is the most widely used system to describe renal injuries and carries management and prognostic implications. CT with intravenous contrast is the imaging test of choice to assess for renal injuries. Contrast extravasation indicating active bleeding should be mentioned as its presence is predictive for failure of nonoperative management. Radiologists play a critical role in identifying renal injuries and should make every effort to describe renal injuries according to the AAST grading scheme to better inform the surgeon's management decisions.