Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May;32(5):553-559.
doi: 10.1111/iju.70006. Epub 2025 Feb 7.

Ureteral contrast findings as a potential predictor for invasive intervention in high-grade pediatric renal trauma: A retrospective analysis

Hansen Lui  1 , Phillip J Kim  1 , Lisa H Kang  2 , Blythe P Durbin-Johnson  3 , Eric A Kurzrock  1
Affiliations

Ureteral contrast findings as a potential predictor for invasive intervention in high-grade pediatric renal trauma: A retrospective analysis

Hansen Lui et al. Int J Urol. 2025 May.

Abstract

Objectives: To determine if patient variables were associated with intervention in pediatric patients presenting with high-grade renal injuries.

Methods: A retrospective review of pediatric patients presenting with grade IV/V renal injury between 2003 and 2021 at a Level 1 trauma center was performed. Renal injury grade was verified and updated based upon the 2018 American Association for the Surgery of Trauma injury scale. Multivariable logistic regression analyses were performed.

Results: Seventy-five patients (median age 13 years old, IQR 9-16) with Grade IV (n = 53) or Grade V (n = 22) injury were identified. 33% (25/75) had immediate renal intervention within 24 h of admission. Of the remaining 50 children who were observed, 47 had blunt trauma, and outcomes were analyzed. The median age of observed patients was 12 years (IQR 8-14) and 30% (14/47) had intervention. Delayed images on CT showed ureteral contrast was present in 87% (41/47) of observed patients. Multivariable analysis demonstrated that the presence of contrast in the ureter is associated with significantly lower odds of intervention, OR 0.06 [0-0.73, 95% CI], p = 0.03.

Conclusion: After grades IV and V blunt renal injury, for those children who are considered safe to observe, AAST grade of injury did not associate with procedural intervention. The presence of contrast in the ureter on delayed CT imaging was associated with a significantly lower odds of procedural intervention.

Keywords: high‐grade; pediatrics; renal trauma; urogram.

PubMed Disclaimer

Conflict of interest statement

The named authors have no conflict of interest, financial or otherwise.

Figures

FIGURE 1
FIGURE 1
Flowsheet diagram of blunt renal trauma Grade IV and V patients upon admission.
FIGURE 2
FIGURE 2
CT of blunt renal trauma with examples of delayed imaging.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Brown SL, Elder JS, Spirnak JP. Are pediatric patients more susceptible to major renal injury from blunt trauma? A comparative study. J Urol. 1998;160:138–140. - PubMed
    1. Broghammer JA, Langenburg SE, Smith SJ, Santucci RA. Pediatric blunt renal trauma: its conservative management and patterns of associated injuries. Urology. 2006;67:827. - PubMed
    1. Fraser JD, Aguayo P, Ostlie DJ, St. Peter SD. Review of the evidence on the management of blunt renal trauma in pediatric patients. Pediatr Surg Int. 2009;25:125–132. - PubMed
    1. Coccolini F, Moore EE, Kluger Y, Biffl W, Leppaniemi A, Matsumura Y, et al. Kidney and uro‐trauma: WSES‐AAST guidelines. World J Emerg Surg. 2019;14:54. - PMC - PubMed
    1. Mann U, Zemp L, Rourke K. Contemporary management of renal trauma in Canada: a 10‐year experience at a level 1 trauma center. Can Urol Assoc J. 2019;13:177–182. - PMC - PubMed

LinkOut - more resources