[Skip to Content]
[Skip to Content Landing]
Views 384
Citations 0
JAMA Surgery Clinical Challenge
August 2018

Computed Tomography in a Patient With Blunt Trauma

Author Affiliations
  • 1Department of Surgery, University of Colorado School of Medicine, Aurora
  • 2Department of Surgery, Denver Health Medical Center, Denver, Colorado
JAMA Surg. 2018;153(8):772-773. doi:10.1001/jamasurg.2018.0307

A man in his 60s with a known history of a large cyst on the right kidney sustained blunt trauma in a skiing crash. Computed tomography (CT) showed a right-sided grade IV renal injury involving his known renal cyst with active arterial extravasation (Figure, A). The patient underwent selective angioembolization of the renal laceration.

In the 24 hours after embolization, the patient required 2 U of red blood cells via transfusion for anemia. On examination, the patient reported moderate pain in the abdomen and right side and demonstrated a distended abdomen in the absence of any peritoneal signs. Contrast-enhanced CT of the abdomen and pelvis was performed to assess for a source of continued bleeding (Figure, B).

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words