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Question 1#

What specific urological imaging investigation should be requested for a stable patient following blunt abdominal trauma who has dipstick haematuria?

A. CT KUB
B. IVU
C. Renal tract ultrasound
D. Contrast enhanced CT with 10 minute delayed scan
E. None of the above

Correct Answer is E

Comment:

Answer E

Jack McAninch’s data from the San Francisco General Hospital involved over 2000 patients with renal trauma at the time (1995) when it was recommended that stable patients with dipstick haematuria require no imaging. This was based on the findings that these patients very rarely had significant renal injuries and that in fact no significant injuries were missed in the non-imaged cohort of patients (1004). The accepted exception is a high index of suspicion of significant renal injury (e.g., fall from height and rapid deceleration injury). This is also supported by the EAU guidelines.