Diagnostic imaging of renal pedicle injury

H Shima; S Nosaka; M Hayakawa; H Kawaguchi; M Wakabayashi; M Saeki; T Yamaguchi; Y Nakajima; T Ishikawa

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Journal article

Diagnostic imaging of renal pedicle injury

H Shima, S Nosaka, M Hayakawa, H Kawaguchi, M Wakabayashi, M Saeki, T Yamaguchi, Y Nakajima and T Ishikawa

Nihon Igaku Hoshasen Gakkai zasshi. Nippon acta radiologica, Vol.57(1), pp.5-11

01/1997

PMID: 9038056

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Abstract

We reviewed the radiological findings of 8 patients with renal pedicle injury admitted to our emergency center from January 1986 through September 1995 and compared them with the previously reported findings. The patients included 3 with renal artery occlusion and 5 with avulsion or disruption of renal pedicle vasculature. Extended retroperitoneal hematoma such as contralateral pararenal or central parahilar hematoma was visualized in all 5 cases with avulsion or disruption of renal pedicle vasculature. Although lack of contrast enhancement of injured renal parenchyma is a hall-mark of renal pedicle injury, three cases did not demonstrate this typical finding. In these three cases, one showed partial and the others showed total enhancement of the injured renal parenchyma on contrast enhanced CT. Partial enhancement in one case was found to represent total occlusion of the main renal artery and an intact accessory polar branch on angiography. The other two cases showed total enhancement of the renal parenchyma, with renal vein perforation done and complete disruption of the main renal artery and vein in the other. The latter findings were thought to be due to the maintenance of vascular flow surrounded by hematoma. In conclusion, when central parahilar hematoma is identified, the possibility of renal pedicle injury should be considered even if the renal parenchyma is well enhanced.

Angiography

Kidney - blood supply

Humans

Middle Aged

Hematoma - diagnostic imaging

Male

Tomography, X-Ray Computed

Kidney Diseases - diagnostic imaging

Kidney - injuries

Kidney - diagnostic imaging

Adolescent

Adult

Female

Retrospective Studies

Renal Artery Obstruction - diagnostic imaging

Details

Title: Subtitle: Diagnostic imaging of renal pedicle injury
Creators: H Shima - Department of Radiology, St. Marianna University School of Medicine
S Nosaka
M Hayakawa
H Kawaguchi
M Wakabayashi
M Saeki
T Yamaguchi
Y Nakajima
T Ishikawa
Resource Type: Journal article
Publication Details: Nihon Igaku Hoshasen Gakkai zasshi. Nippon acta radiologica, Vol.57(1), pp.5-11
Publisher: Japan
PMID: 9038056
ISSN: 0048-0428
Language: Japanese
Date published: 01/1997
Academic Unit: Neurology; Radiology
Record Identifier: 9984020781202771

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