Use of hematoma size on computerized tomography and calculated average bleeding rate as indications for immediate surgical intervention in blunt renal trauma.

One of the most demanding situations for a urologist is to decide which blunt renal trauma patients need immediate surgical exploration. Although computerized tomography can offer a lot of invaluable information, clear guidelines for selection of surgical versus conservative treatment are still lacking. A retrospective study of 15 blunt renal trauma cases showed that the hematoma size measured from computerized tomography using the method of summation planimetry bears a much closer correlation with the clinical outcome of the patient than does the degree of kidney parenchymal defect. Moreover, the average bleeding rate, calculated by dividing the size of the hematoma by the time elapsed from injury to scanning, gives a more accurate prediction for the need for immediate surgical treatment.