ROLE OF ULTRASONOGRAPHY VERSUS COMPUTED TOMOGRAPHY IN EVALUATION OF RENAL TRAUMA

Abstract

Trauma is a leading cause of morbidity and mortality, however the kidney is placed high up in the retroperitoneal space and well protected by other abdominal viscera and musculoskeletal structures of the posterior abdominal wall, it is still the most commonly involved viscera in urogenital tract especially in pediatric age because of its larger size and less well protected. Renal injury is seen in approximately 8-1Oo/oof patients with blunt or penetrating abdominal injuries but the vast majority 80-90% of renal injury are due to blunt rather than penetrating injuries Many methods of investigation are used for diagnosis of renal injury , among which ultrasonography remains the first choice of imaging modality , as it is quick , non invasive and often readily available for urgent assessment , and its capability to detect other solid organ injury such as hepatic or splenic injury is generally considered . But significant under evaluation of major renal parenchymal injury using B-mode ultrasound was encountered specially after subsequent computerized tomography or obtained operative data, so it is not a step to stand at in proper evaluation of renal injury even with negative results. Doppler study added some advantages in assessment of renal vascular pedicles and post-traumatic areas of segmental or subsegmental renal infarction but it is not always available and need experienced hand Although intravenous urography is no longer the primary modality for the assessment of suspected renal injuries as it is replaced by dynamic CT scanning and it has a disadvantage of time consumption . The use of renal angiography in assessment of renal injuries has diminished because most vascular injuries can be assessed with CT.