Intra-abdominal and retroperitoneal organ injuries diagnosed on dynamic computed tomograms obtained for assessment of renal trauma.

The efficacy of dynamic computed tomography in assessment of renal, intra-abdominal, and retroperitoneal organ injuries is analyzed in some 444 patients. This technique contributed most valuable information toward the diagnosis of such coexistent injuries in patients who sustained blunt trauma. CT identified associated abdominal or retroperitoneal organ injuries in 85% of the patients (277 of 324), clinical examination in only 26%. CT proved invaluable for assessment of injury to bowel and mesentery, pancreas, and retroperitoneal vascular structures, giving rise to hematomas. CT diagnosed all such injuries, clinical examination from 0% (pancreas) to 11% (retroperitoneal hematomas). In patients with penetrating injury, dynamic CTs added valuable information on the status of viability of the injured organs. A relatively high number of false positive diagnoses resulted in only four unnecessary explorations. In all other patients, the erroneous diagnosis was revealed on repeat CTs undertaken because of inconsistency of the clinical course and clinical findings with the initially suggested CT diagnosis or at time of exploration undertaken for correction of other confirmed injuries. Discovery of associated intra- or retroperitoneal organ injuries, particularly in patients who sustained blunt trauma, has resulted in modification of treatment which prevented late sequelae and complications and thereby substantially reduced hospitalization time.