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September 1988

Hematuria Following Blunt Abdominal Trauma: The Utility of Intravenous Pyelography

Author Affiliations

From the Department of Surgery, Harbor-UCLA Medical Center.

Arch Surg. 1988;123(9):1173-1177. doi:10.1001/archsurg.1988.01400330153024

• To clarify the indications for intravenous pyelography (IVP) and nephrotomography (NT) in the evaluation of patients with hematuria following blunt thoracoabdominal trauma, we performed a retrospective analysis of patients admitted during a one-year period who had undergone IVP and NT for suspected renal injury. One hundred thirty-four patients were reviewed, and the findings of IVP and NT correlated with the magnitude of hematuria on urinalysis, associated injuries, management, and outcome. Sixty-two (46%) of 134 patients had fewer than ten red blood cells per high-power field (RBCs/HPF) on urinalysis (group 1), 19 (14%) of 134 patients had 10 to 30 RBCs/HPF (group 2), and 53 (40%) of 134 patients had greater than 30 RBCs/HPF (group 3). Twenty-seven patients had renal injuries detected by IVP and NT, two in group 2 and 25 in group 3. We conclude that IVP and NT should be reserved for patients with greater than 30 RBCs/HPF on admission urinalysis.

(Arch Surg 1988;123:1173-1177)