Unilateral absence of excretion at urography after abdominal trauma.

The unilateral absence of excretion at urography is particularly significant in the context of prior abdominal trauma. Of 23 such cases studied, 17 involved traumatic main renal artery occlusion; only 1 of these 17 kidneys was salvaged. Since earlier diagnosis may improve surgical results, urography should be abbreviated in favor of renal angiography, to differentiate renal artery occlusion from other renal injuries, agenesis, and preexisting renal disease. Clinical and plain radiographic features provide few clues. Renal venography, ultrasonography, and retrograde ureteropyelography should be used only as secondary procedures. The role of renal scintiangiography remains to be determined.