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Case of the Month

February 2013

Patient Data: Boy 15 year old

Clinical Info: Trauma with a fall on the right flank and hematuria


48706-Afbeelding1.jpg
Longitudinal view with an abnormal right kidney with a normal upperpole and abnormal lowerpole with a large perirenal mass


48707-Afbeelding2.jpg
Another longitudinal image. The mass is a large perirenal hematoma


48708-Afbeelding3.jpg
Another longitudinal view showing a defect in the renal perenchyma


48710-4109741_20120913__0004.swf video longitudinal plane, dorsal approach


48711-4109741_20120913__0005.swf video transverse plane dorsal approach


48712-4109741_20120913__0013.swf video


48713-renal_laceration_1.swf CT early (arterial) phase


48714-renal_laceration_2.swf CT late phase. The large renal defects and the large perirenal hematoma are clearly seen


48715-Afbeelding5.jpg
This is a longitudinal image of the right kidney of a 22 year old motorcyclist who also has suffererd an accident


48716-Afbeelding6.jpg
Another longitudinal image of the same kidney clearly showing a perirenal hematoma


48717-renal_rupture.swf CT scan of the same patient in the early arterial phase


48718-renal_rupture_2.swf CT axial plane


48719-Afbeelding7.jpg
Because the patient had a rapid drop in Hb he underwent an angiography to see if an embolisation procedure was necessary. There is extravasation of contrast


48720-Afbeelding8.jpg
A later phase image shows spreading of the contrast outside the artery. An embolisation procedure was performed and the patient stabilized

Both patients had an almost identical looking renal rupture with a large perirenal hematoma The first patient was conservatively treated and did well without any intervention. The second patient underwent an embolisation treatment and did well afterwards.

For more examples of traumatic renal lesions see

Copyright © Dr. T.S.A. Geertsma, Ziekenhuis Gelderse Vallei, Ede, The Netherlands. All rights reserved.

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