The role of computed tomography in renal trauma.

Computed tomography (CT) and excretory urography were performed in 15 patients thought to have major renal trauma. In 4 cases, CT demonstrated extravasation of urine not detected by urography, and in all cases parenchymal injuries and extrarenal hematomas were depicted more accurately by CT. CT also proved to be superior to excretory urography in distinguishing relatively minor renal injuries (confusion, incomplete laceration, intrarenal hematoma, small extrarenal hematoma) from major or catastrophic injuries (complete laceration, fracture, shattered kidney), which significantly influenced the choice of surgical or medical therapy. CT also detected concurrent injuries of the spleen, liver, and/or pancreas in 4 cases. The authors feel that CT is valuable in the assessment of major renal trauma.