Role of multidetector computed tomography findings in grading renal injuries at Assiut University Hospital

Aim
To assess the performance of our Radiological Department and value of multidetector computed tomography (MDCT) in renal injured patients at Assiut University Hospital during 1 year.
Patients and methods
This prospective study was done in the period from April 2017 to March 2018 in Assiut University Hospital on all patients with renal trauma who presented to the trauma unit diagnosed as having renal trauma by CT with contrast and to correlate the findings seen in the MDCT with clinical and operative data of patients with renal injuries.
Results
Of the 61 traumatized patients who came to the trauma unit of Assiut University Hospitals with different forms of renal injuries, 48 (78.7%) were males and 13 (21.3%) were females. The range of age of those patients was between 1 and 70 years, with a mean age of 23.18 years. The cause of injury in 55 (90.2%) patients was blunt trauma, whereas penetrating trauma (firearm and stab wound) was present in six (9.8%) patients. Of the enrolled patients, 13 (21.3%) patients were hemodynamically unstable. Hematuria was present in 37 (60.7%) patients and 24 (39.3%) patients had clear urine. Conservative management was the main line for renal injuries in the current study, where 44 (72.1%) patients were followed conservatively. Nephrectomy was done in 12 (19.7%) patients, whereas renal repair was done in three (4.9), and angioembolization and double J stent were required in one patient each. Of the enrolled patients, 56 (91.8%) patients improved and survived.
Conclusion
Contrast-enhanced MDCT may be the best imaging modality for the assessment of renal trauma and other involved organs, as it provides significant anatomic and functional details essential to establish the type and extent of vascular, collecting system, or parenchymal injuries. Developments in CT techniques are useful for the patient choice for the best treatment and to prevent failure of conservative treatment.