Renal Trauma
In a stable blunt trauma patient, these clinical findings should prompt the physician to order a CT with IV contrast with immediate and delayed images.
What is gross hematuria or microscopic hematuria and SBP <90 mmHG?
During a CT Urogram, delayed imaging is typically performed at this time point.
What is 10 minutes?
These clinical findings in a stable patient should prompt the physician to order a cystogram (plain film or CT).
What is gross hematuria and pelvic fracture?
Blood at the meatus after pelvic trauma should prompt this diagnostic test.
What is retrograde urethrogram?
These are classic history and physical findings in a penile fracture case.
What is penile ecchymosis, swelling, pain, cracking or snapping sound during intercourse or manipulation and immediate detumescence?
These physical exam findings and mechanisms of injury are associated with renal injury.
What is rapid deceleration, significant blow to flank, rib fracture, significant flank ecchymosis, penetrating injury of abdomen, flank, lower chest?
Intact but contused ureters, found at the time of laparotomy, should be managed with this surgical technique in the majority of cases.
What is ureteral stenting?
This is the minimum recommended volume of contrast to fill the bladder for a cystogram study.
What is 300 mL?
This is the preferred method of urinary drainage in most PFUI cases.
What is SPT placement?
These 2 imaging studies can be considered in penile fracture cases that are equivocal.
What is penile US and MRI?
Non-invasive management vs. immediate intervention is based on this clinical finding.
What is hemodynamic stability?
Incomplete ureteral injuries diagnosed postoperatively or in the delayed setting should be managed with this surgical approach.
What is ureteral stenting (or pcn if ureteral stent is not successful)?
Intraperitoneal injuries typically occur at this location in the bladder and require this type of intervention.
What is the bladder dome and surgical repair?
This piece of clinical information is important to communicate to orthopedic surgeons (professionally) regarding SPT placement in the setting of pelvic fracture.
What is the fact that no evidence exists to indicate that SPT insertion increases the risk of orthopedic hardware infection.
Evaluation of concomitant urethral injury should be performed during penile fracture repair if the patient has these findings.
What is blood at the urethral meatus, gross hematuria, inability to void, and bilateral corporal body fracture?
These specific CT findings can be indicative of an active renal bleed.
What is large perirenal hematoma > 4 cm and/or vascular contrast extravasation?
Recent studies of patients with ureterovaginal fistula who are initially managed with ureteral stent placement report this success rate range.
What is 64-100%?
Uncomplicated extraperitoneal bladder injuries should undergo catheter placement for this amount of time prior to reimaging.
What is 2-3 weeks?
Uncomplicated penetrating trauma of the anterior urethra should undergo this treatment in the majority of cases.
What is prompt surgical repair?
These are the indications for prompt surgical repair of blunt scrotal trauma.
What is sonographic findings of testicular rupture, equivocal imaging, large hematoma, or clear physical findings of testicular rupture?
These groups of patients should undergo follow up CT imaging ~48 hours after initial imaging.
What is Grade 4 or 5 injuries or clinical signs of complications (fever, worsening flank pain, ongoing blood loss, abdominal distention)?
Ureteral reimplant should be considered for ureteral injuries at this location.
What is distal to the iliac vessels?
Complicated extraperitoneal bladder ruptures should be surgically repaired and are defined by the following clinical findings.
What is pelvic fractures that result in exposed bone spicules in the bladder lumen, concurrent rectal or vaginal lacerations, bladder neck injuries, patients already undergoing open reduction internal fixation or repair of abdominal injuries
PFUI typically occur at this location in the urethra.
What is the bulbomembranous junction?
In traumatic penile amputation cases, this is how the amputated appendage should be transported.
What is wrapped in saline-soaked gauze, in a plastic bag and placed on ice during transport?