Imaging of renal trauma

Trauma is a major cause of death and disability and renal injuries occur in up to 10% of patients with significant blunt abdominal trauma. Patients with penetrating trauma and hematuria, blunt trauma with shock and hematuria, or gross hematuria warrant imaging of the urinary tract specifically, and CT is the preferred modality. If there is significant perinephric fluid, especially medially, or deep laceration, delayed images should be obtained to evaluate for urinary extravasation. Active hemorrhage should be recognized because it often indicates a need for urgent surgery or embolization to prevent exsanguination.