Blunt abdominal trauma: Grade II renal injury

Case contribution: Dr Radhiana Hassan


  • A 22 years old male
  • Alleged MVA, mb vs car
  • Complaint of left abdominal pain and hematuria
  • Clinically abdomen is not distended, no tenderness
Contrast-enhanced CT scan of abdomen and pelvis in axial plane with soft tissue window

CT scan findings:

  • There is a short laceration at lower pole of left kidney
  • There is no extension of the injury to the collecting system
  • Minimal perinephric streakiness is seen
  • No contrast extravasation is seen
  • No other injury involving solid organ.
  • No free air in the peritoneal cavity

Progress of patient:

  • Patient was managed conservatively
  • Recovered well, discharged from hospital after 5 days admission

Diagnosis: Grade II renal injury


  • Renal injury occurs in approximately 1% to 5% of all traumas.
  • Blunt injuries are usually secondary to high-energy collisions such as motor vehicle accidents, falls from a height, and contact sports.
  • CT grading of renal injury directly correlates with the need for intervention, nephrectomy, dialysis, and mortality.
  • Grade II renal injury refers to superficial laceration less than 1 cm in depth in the renal cortex or non-expanding perirenal hematoma confined to the retroperitoneum.
  • Stable patients with Grades I-IV injuries can generally be managed conservatively.
Author: radhianahassan