Hematuria: Part I: The trauma patient

J. R. Avner

Research output: Contribution to journalShort surveypeer-review

1 Scopus citations

Abstract

Hematuria remains the hallmark of renal trauma, although its absence does not necessarily rule out renal injury. It is imperative that the physician obtain a urine sample in the case of any injury where there was trauma to the back or abdomen - no matter how mild the mechanism of the injury. Although there remains some controversy as to which children with hematuria need radiographic evaluation, there is no question that all children need a careful examination and follow-up. The following guidelines may be helpful in the evaluation of children with hematuria following blunt trauma: (1) If the child sustained minor or moderate trauma, there is no flank gain, and the urinalysis shows < 20 RBCs/hpf, careful follow-up is recommended. (2) If there have been recurrent episodes of microscopic hematuria following minor trauma, a renal ultrasound study should be obtained to rule out an underlying anatomic abnormality. (3) If the child has flank pain, hematuria ≥ 20 RBCs/hpf, microscopic hematuria and shock, or a low rib or pelvic fracture, an IVP should be obtained. A CT scan should be reserved for the child with hematuria associated with abdominal pain or if there is suspicion of an associated injury. An algorithm is shown in Figure 1.

Original languageEnglish (US)
Pages (from-to)144-147
Number of pages4
JournalEmergency and Office Pediatrics
Volume7
Issue number6
StatePublished - Dec 1 1994

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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