Pediatric emergency medicine trisk 3318 3318
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FIGURE 108.3 Renal fracture. Computed tomography section of the abdomen shows fracture
of the left kidney with moderate subcapsular hematoma.
Angiography
Angiography has been largely replaced by noninvasive modalities, especially in
the pediatric patients in whom technical problems with vascular access result in a
higher complication rate than in adults. Arteriography does not add useful
information to contrast CT scanning and may increase diagnostic delay during the
preoperative workup.
It is however quite useful in patients who require therapeutic embolization of
an active bleeding site (generally segmental artery or more distal) and may be
considered as first-line therapy in such cases.
Nuclear Medicine Imaging and MRI
Currently, there is no role for radionuclide imaging (DMSA, MAG3) or magnetic
resonance imaging (MRI) in the acute setting for children with suspected renal
trauma although there is a role in the follow-up evaluation of renal injury and
long-term renal function.
Clinical Indications for Discharge or Admission
