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Renal Trauma

meredith mcbride trauma-list@trauma.org
Tue, 1 Apr 2003 16:55:32 -0800 (PST)


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Foley cath, bedrest until urine becomes clear. Follow Hb, exam, serum creatinine. Low elevation in creatinine can indicate urinoma or unilateral loss of kidney function.
Consider IVP to confirm patent ureter (blood clot common). Urine extravasation often responsive to stenting, drainage.
 DocRickFry@aol.com wrote:In a message dated 4/1/2003 4:19:15 PM Eastern Standard Time, pedrogrt@uol.com.br writes: 


irritation sign. He spontaneously urinated (frank hematuria). An abdominal 
CT was ordered and showed a right kidney augmented in size and with a slow 
captation of contrast. There was no sign of parenquimal disruption or 
extravasation of contrast. Excretion was slow but present. The CT also 
showed blood clots inside the bladder and right renal pelvis. Left kindey 
normal on CT. 

What next? Angiogram? Observe? 

When are we supposed to order a control CT (early and late)? 



Observe--operate if becomes unstable or peritonitis develops.  Repeat abdominal CT at some point in the near future (the last not based on any data--just would like to confirm no worsening) 
ERF 


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<P>Foley cath, bedrest until urine becomes clear. Follow Hb, exam, serum creatinine. Low elevation&nbsp;in creatinine can&nbsp;indicate urinoma or unilateral loss of kidney function.
<P>Consider IVP to confirm patent ureter (blood clot common). Urine extravasation often responsive to stenting, drainage.
<P>&nbsp;<B><I>DocRickFry@aol.com</I></B> wrote:
<BLOCKQUOTE style="PADDING-LEFT: 5px; MARGIN-LEFT: 5px; BORDER-LEFT: #1010ff 2px solid"><FONT face=arial,helvetica><FONT size=2>In a message dated 4/1/2003 4:19:15 PM Eastern Standard Time, pedrogrt@uol.com.br writes: <BR><BR><BR>
<BLOCKQUOTE style="PADDING-LEFT: 5px; MARGIN-LEFT: 5px; BORDER-LEFT: #0000ff 2px solid; MARGIN-RIGHT: 0px" TYPE="CITE">irritation sign. He spontaneously urinated (frank hematuria). An abdominal <BR>CT was ordered and showed a right kidney augmented in size and with a slow <BR>captation of contrast. There was no sign of parenquimal disruption or <BR>extravasation of contrast. Excretion was slow but present. The CT also <BR>showed blood clots inside the bladder and right renal pelvis. Left kindey <BR>normal on CT. <BR><BR>What next? Angiogram? Observe? <BR><BR>When are we supposed to order a control CT (early and late)? <BR><BR></FONT><FONT lang=0 face=Arial color=#000000 size=3 FAMILY="SANSSERIF"></BLOCKQUOTE><BR></FONT><FONT lang=0 face=Arial color=#000000 size=2 FAMILY="SANSSERIF"><BR>Observe--operate if becomes unstable or peritonitis develops. &nbsp;Repeat abdominal CT at some point in the near future (the last not based on any data--just would like to confirm no worsening) <BR>ERF</FONT> </BLOCKQUOTE></FONT><p><br><hr size=1>Do you Yahoo!?<br>
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