Hematuria following blunt abdominal trauma. The utility of intravenous pyelography

S. Klein, S. Johs, R. Fujitani and D. State
Department of Surgery, Harbor-UCLA Medical Center, Torrance 90509.

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.