Pediatric emergency medicine trisk 3311 3311
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FIGURE 108.1 Algorithm for the evaluation of the pediatric patient with genitourinary trauma.
IVP, intravenous pyelogram; CT, computed tomography; RBC, red blood cell; HPF, highpowered field; UAs, urinalyses.
Current Evidence
Approximately half of all genitourinary injuries involve the kidney. Most
pediatric renal trauma is minor, requiring no intervention. Children are more
likely than adults to sustain renal injuries for the following reasons: The pediatric
kidney is larger in proportion to the size of the abdomen than in adults; the child’s
kidney may retain fetal lobations which allow for easier parenchymal disruption;
the pediatric kidney has inadequate protection due to weaker abdominal
musculature, a less well-ossified thoracic cage, and less developed perirenal fat
and fascia than in adults.
