Cass A S, Luxenberg M
J Urol. 1984 Aug;132(2):225-7. doi: 10.1016/s0022-5347(17)49572-3.
Unilateral nonvisualization on excretory urography after external trauma indicates serious consequences for the kidney, since traumatic main renal artery occlusion has been the most common cause of this finding. We evaluated 53 patients with unilateral nonvisualization on excretory urography following blunt (47) and penetrating (6) trauma. All but 1 patient had multiple injuries from severe external trauma. The renal injury causing the nonvisualization was contusion in 8 patients, laceration in 12, rupture in 12 and renal pedicle in 21. Further investigations required to diagnose the type of renal injury consisted of repeat excretory urography in 2 patients, renal arteriography in 14, renal exploration in 36 and autopsy in 1. Early diagnosis was mandatory if the kidney was to be salvaged by surgical repair of the main artery occlusion or if the appropriate management was to be used for the lesser degrees of renal injury, such as rupture, laceration and contusion.
外伤后排泄性尿路造影单侧不显影提示肾脏有严重后果，因为创伤性主肾动脉闭塞是这一表现最常见的原因。我们评估了53例钝性伤（47例）和穿透伤（6例）后排泄性尿路造影单侧不显影的患者。除1例患者外，所有患者均因严重外伤而有多处损伤。导致不显影的肾损伤为挫伤8例、裂伤12例、破裂12例、肾蒂损伤21例。诊断肾损伤类型所需的进一步检查包括2例患者重复排泄性尿路造影、14例肾动脉造影、36例肾探查和1例尸检。如果要通过手术修复主动脉闭塞来挽救肾脏，或者要对较轻程度的肾损伤（如破裂、裂伤和挫伤）采用适当的治疗方法，早期诊断是必不可少的。
