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The Utility of Intravenous Pyelography

Stanley Klein, MD; Stephen Johs, MD; Roy Fujitani, MD; David State, MD

Arch Surg. 1988;123(9):1173-1177.

Abstract
• 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)

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

Footnotes
Accepted for publication May 5, 1988.

Read before the 59th Annual Meeting of the Pacific Coast Surgical Association, San Francisco, Feb 22, 1988.

Reprint requests to the Department of Surgery, Harbor-UCLA Medical Center, Box 304, 1000 W Carson St, Torrance, CA 90509 (Dr Klein).

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