We retrospectively reviewed medical records of 429 patients who were admitted to and treated in the surgical department of Daihan Hospital with evidence of blunt trauma during the past 5 years, from January 1990 to December 1994.
Among these patients, 329 patients(76%) had significant hematuria(>5RBCs/HPF), 87 patients were found to have both hematuria and significant intra-abdominal injury not definitely related to the genitourinary system.
We studied hematuria as a marker of extra-renal abdominal injury and the presence of hematuria should be added to the list of objective clinical criteria that prompt early diagnostic evaluation of the abdomen after blunt abdominal trauma.
The incidence of abdominal injury generally increased with the degree of hematuria, approaching 49.2% in patients with grosss hematuria. For each category of degree of hematuria, patients with shock had a significantly higher incidence of
abdominal
injury(p<0.05) than patients without shock.
In conclusion, we have demonstrated that hematuria is a good marker for both renal and extra-renal abdominal injuries after blunt abdominal trauma. All patients with gross hematuria should be evaluated for both renal and associated abdomial
injuries. In
addition, patients with a history of shock and microscopic hematuria after blunt abdominal trauma should also be suspected of having abdominal injuries.
More studies of this nature should help to standardize the abdominal conditions(by CT scanning, DPL, abdominal sonogram, or laparotomy), in an effort to minimize morbidity and mortality after blunt abdominal trauma.
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