Incidence and Degree of Traumatic Kidney Injury in Polytrauma Patients Detected by Ultrasound versus Computed Tomography of the Abdomen

Abstract

Background: Trauma has been considered a frequent cause of death or permanent disability in young subjects; hence, a timely  diagnostic approach is crucial. In polytrauma cases, contrast-enhanced ultrasound (CEUS) has been demonstrated to be of great  sensitivity compared to ultrasound (US) in the detection of solid organ traumas.

Objective: To evaluate the incidence and degree of  traumatic kidney injury (TKI) in polytraumatic patients detected by ultrasound versus CT scan of the abdomen and effect of renal injuries  on short term outcome.

Patients and Methods: This was a prospective study included 65 polytrauma patients with traumatic kidney  injury. They were subjected to history taking including mechanism of injury and time of the injury and injury severity score (ISS), clinical  examination, laboratory and radiological investigations (Fast abdominal Ultrasound and CT abdomen with contrast).

Results: No  statistically significant relation was found between grades of renal trauma by CT and need of ICU admission, needing blood transfusion,  sepsis and ICU stay duration. US validity in detecting renal trauma as compared to CT findings was highest among cases with hyperechoic  or hypoechoic collection followed by perinephric collection hematoma, pelvic free fluid and subcapsular hematoma or  collection.

Conclusion: Both ultrasound and CT are effective tools for detecting traumatic kidney injuries, with CT exhibiting a higher  sensitivity and specificity. The degree of traumatic kidney injury varied significantly among the study population, highlighting the  heterogeneity of polytrauma patients and the need for individualized treatment approaches.