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KMID : 0876319990010020101
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Cachon Medical Journal
1999 Volume.1 No. 2 p.101 ~ p.105
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Computerized Tomography as Primary Radiographic Investigation in Blunt Renal Trauma : is it a Diagnostic ´Overkill´?
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Lee Jong-Bouk
Hwang Sang-Gil
Cho Seung-Phil
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Abstract
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Purpose: To evaluated the cost-effectiveness of computerized tomography (CT) of the abdomen as primary radiographic investigation for patients with suspected blunt renal trauma that meet the criteria for radiographic assessment.
Materials and Methods: From June 1993 to August 1998, abdominal CT was performed as routine radiographic study for the patients who visited the emergency center due to the blunt abdominal trauma with hematuria excluding adults presented with microhematuria and no shock. Renal injuries were classified into 5 grades according to the CT results and evaluated the efficacy of CT as primary radiographic investigation.
Results: Total 158 patients (31 children and 127 adults) met the criteria of our study. Of the 158 patients, grade I was 69(43.7%), grade II 32(20.3%), grade III 23 (14.6%), grade IV 26 (16.5%) and grade V 8(5.1%). Associated intra-abdominal organ injuries were detected in 31 (19.6%) patients. The rate of major renal injuries (grade III-V), which were considered to need CT as a radiographic study, was 36%. Twenty-nine (18.4%) patients underwent operative treatment and the grade between preoperative and intraoperative time was identical in all patients.
Conslusions: The results of this study show that CT should be performed for at least one-third of patients with blunt renal trauma. We recommend the CT as primary diagnostic investigation instead of the IVP when radiographic study is indicated.
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KEYWORD
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Blunt renal trauma, Computerized tomography
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