Children are more likely to be exposed to blunt trauma-induced kidney damage due to the lack of perirenal adipose tissue, weakness in the abdominal muscles, and less ossified thoracic cage. Grade 5 renal injury may be an indication for urgent surgical intervention. Here, we describe a case of pediatric blunt trauma with initial computerized tomography (CT) scan demonstrating complete renal devascularization suggestive of grade 5 renal injury. However, subsequent imaging demonstrated normal vascularization of the kidney. Renal artery spasm was likely the cause for the initial CT findings, which mimicked a grade 5 renal injury.
Moore EE, Shackford SR, Pachter HL, McAninch JW, Browner BD, Champion HR, , et al. Organ injury scaling: spleen, liver, and kidney. J Trauma. 1989;29(12):1664-66.
Federle MP, Brown TR, McAninch JW. Penetrating renal trauma: CT evaluation. J Comp Assist Tomogr. 1987;11(6):1026–30.
Altman AL, Haas C, Dinchman KH, Spirnak JP. Selective nonoperative management of blunt grade 5 renal injury. J Urol. 2000;164(1):27-30.
Ucar A, Yahyayev A, Agayev A, Yanar F, Bakan S, Bulakci M, et al. Severe spasm of the renal artery after blunt abdominal trauma simulating end-organ infarction. Case Rep Med. 2010; Article ID 207152: 3 pages.
Kurihara O, Seino Y, Shibata Y, Matsushita M, Komiyama H, Kato K, et al. Blunted renal vasoconstriction in patients with subclinical contrast-induced renal injury. Clin Exp Pharmacol Physiol. 2016;43(11):1148-50.