Introduction

Renal trauma is the most common type of genitourinary injury. In the management of renal trauma, a repeat imaging is recommended two to seven days after the initial trauma to seek for missed complications. However, the data on which this recommendation is based are scarce and controversial._x000D_ The aim of this study was to evaluate the impact of the routine use of repeat imaging after renal trauma.

Methods

A nationwide multicentric retrospective study including all patients referred for renal trauma has been conducted in fifteen trauma centers between 2005 and 2015. Patients were divided into three groups : no routine repeat Imaging (NRIM), repeat imaging in asymptomatic patient (SYSTIM), repeat imaging in symptomatic patient (SYMPTIM)._x000D_ The three groups were compared, and multivariate analysis were performed to seek for predictive factors of secondary surgery/interventional radiology, change in patient management and readmission.

Results

Out of 927 patients who were treated fo renal trauma, 758 had repeat imaging (81.8 %) : 583 (76.9 %) had routine repeat imaging while asymptomatic (SYSTIM), 175 (23,1 %) had repeat imaging due to symptoms (SYMPTIM)._x000D_ The median interval between trauma and repeat imaging was five days if there were no symptoms, and seven days if patients had symptoms. A relevant finding was made more frequently in the SYMPTIM group than in the SYSTIM group (57.1 % vs. 24.1 %, p<0.0001)._x000D_ In thirty patients who had routine repeat imaging (5.1 %), secondary surgery/interventional radiology was needed based on imaging findings, : 19 ureteral stent, 4 percutaneous drainage, 6 embolization and a diaphragmatic tear repair._x000D_ Initial management was modified in 64 (38.2 %) patients from the SYMPTIM group. There was no significative difference in terms of readmission in the NRIM group vs. the SYSTIM group (2.9 % vs. 3.6 %, p = 0.81).

Conclusions

In our study, repeat imaging within 10 days following renal trauma was performed in 81.8% of patients but did change the management in only 5.1% of asymptomatic patients. _x000D_ Repeat imaging after renal trauma could be proposed only to symptomatic patients, with active bleeding or urinary extravasation on the initial CT and patients at risk of renal pseudo-aneurysm.

Funding

none