Genitourinary trauma - Revision history

Rossdonaldson1 at 17:16, 3 May 2023

2023-05-03T17:16:02Z

← Revisión anterior		Revisión del 17:16 3 may 2023
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	*Typically divided into:		*Typically divided into:
	**Upper tract injuries (kidney + ureter)		**Upper tract injuries (kidney + ureter)
	***Majority of blunt trauma injuries present with [[hematuria]]
	***Renal pedicle injuries and penetrating injuries to ureter may not cause hematuria
	***Renal injuries are associated with flank hematoma, lower rib fracture, penetrating wounds to flanks
	**Lower tract Injuries (bladder + urethra + genitalia)		**Lower tract Injuries (bladder + urethra + genitalia)
	***Often accompany [[pelvic fracture]]

	==Clinical Features==		==Clinical Features==
			===Upper tract injury===
			*Majority of blunt trauma injuries present with [[hematuria]]
			*Renal pedicle injuries and penetrating injuries to ureter may not cause hematuria
			*Renal injuries are associated with flank hematoma, lower rib fracture, penetrating wounds to flanks

			===Lower tract injury===
			*Often accompanied by signs of [[pelvic fracture]]

	==Differential Diagnosis==		==Differential Diagnosis==

Rossdonaldson1: /* Background */

2023-05-03T17:14:24Z

Background

← Revisión anterior		Revisión del 17:14 3 may 2023
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	*Typically divided into:		*Typically divided into:
	**Upper tract injuries (kidney + ureter)		**Upper tract injuries (kidney + ureter)
	***Majority of blunt trauma injuries present with hematuria		***Majority of blunt trauma injuries present with [[hematuria]]
	***Renal pedicle injuries and penetrating injuries to ureter may not cause hematuria		***Renal pedicle injuries and penetrating injuries to ureter may not cause hematuria
	***Renal injuries are associated with flank hematoma, lower rib fracture, penetrating wounds to flanks		***Renal injuries are associated with flank hematoma, lower rib fracture, penetrating wounds to flanks

Rossdonaldson1 at 17:14, 3 May 2023

2023-05-03T17:14:01Z

← Revisión anterior		Revisión del 17:14 3 may 2023
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	[[File:Blausen 0592 KidneyAnatomy 01.png\|thumb\|Renal anatomy.]]		[[File:Blausen 0592 KidneyAnatomy 01.png\|thumb\|Renal anatomy.]]
	[[File:PMC5265200 13244 2016 536 Fig1 HTML.png\|thumb\|Perinephric space with exaggerated pararenal space to show retroperitoneal structures. Perinephric bridging septa are seen between the left kidney and the adjacent renal fascia.]]		[[File:PMC5265200 13244 2016 536 Fig1 HTML.png\|thumb\|Perinephric space with exaggerated pararenal space to show retroperitoneal structures. Perinephric bridging septa are seen between the left kidney and the adjacent renal fascia.]]
			*Typically divided into:
	~~===~~Upper ~~Tract Injuries~~ (kidney + ureter)~~===~~		**Upper tract injuries (kidney + ureter)
	*Majority of blunt trauma injuries present with hematuria		***Majority of blunt trauma injuries present with hematuria
	*Renal pedicle injuries and penetrating injuries to ureter may not cause hematuria		***Renal pedicle injuries and penetrating injuries to ureter may not cause hematuria
	*Renal injuries are associated with flank hematoma, lower rib fracture, penetrating wounds to flanks		***Renal injuries are associated with flank hematoma, lower rib fracture, penetrating wounds to flanks
			**Lower tract Injuries (bladder + urethra + genitalia)
	~~===~~Lower ~~Tract~~ Injuries (bladder + urethra + genitalia)~~===~~		***Often accompany [[pelvic fracture]]
	*Often accompany [[pelvic fracture]]

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: /* Evaluation */

2023-05-03T17:12:05Z

Evaluation

← Revisión anterior		Revisión del 17:12 3 may 2023
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	****Deceleration injuries even with no hematuria		****Deceleration injuries even with no hematuria
	****Multiple trauma patient		****Multiple trauma patient

			===Diagnosis===
	*CT with IV contrast is the gold standard in assessing renal and GU trauma		*CT with IV contrast is the gold standard in assessing renal and GU trauma
	**More sensitive and specific than IVP, ultrasound, or angiography		**More sensitive and specific than IVP, ultrasound, or angiography
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	**Exception to using IVP over CT is perioperatively in unstable patients requiring immediate operation for other injuries		**Exception to using IVP over CT is perioperatively in unstable patients requiring immediate operation for other injuries
	**Note, CT A/P with IV contrast NOT sensitive enough for [[bladder trauma\|bladder rupture]], requires CT cystography		**Note, CT A/P with IV contrast NOT sensitive enough for [[bladder trauma\|bladder rupture]], requires CT cystography

	~~===Diagnosis===~~

	==Management==		==Management==

Rossdonaldson1: /* Types */

2023-05-03T17:11:10Z

Types

← Revisión anterior		Revisión del 17:11 3 may 2023
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	===Lower Tract Injuries (bladder + urethra + genitalia)===		===Lower Tract Injuries (bladder + urethra + genitalia)===
	*Often accompany [[pelvic fracture]]		*Often accompany [[pelvic fracture]]

	~~===Types===~~
	*[[Renal Injuries]]
	*[[Ureter Injuries]]

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: /* Differential Diagnosis */

2023-05-03T17:10:43Z

Differential Diagnosis

← Revisión anterior		Revisión del 17:10 3 may 2023
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	==Differential Diagnosis==		==Differential Diagnosis==
			{{Lower GU trauma DDX}}
	{{Abdominal trauma DDX}}		{{Abdominal trauma DDX}}
	~~{{Lower GU trauma DDX}}~~

	==Evaluation==		==Evaluation==

Rossdonaldson1 at 17:08, 3 May 2023

2023-05-03T17:08:02Z

← Revisión anterior		Revisión del 17:08 3 may 2023
Línea 1:		Línea 1:
	==~~Upper Tract Injuries (kidney + ureter)~~==		==Background==
	[[File:Urinary system.png\|thumb\|'''(1) Human urinary system:''' (2) kidney; (3) renal pelvis; (4) ureter; (5) urinary bladder (6) urethra. <Br>'''Additional structures:''' (7) adrenal gland; (8) renal artery and vein; (9) inferior vena cava; (10) abdominal aorta; (11) common iliac artery and vein; (12) liver; (13) large intestine; (14) pelvis.]]		[[File:Urinary system.png\|thumb\|'''(1) Human urinary system:''' (2) kidney; (3) renal pelvis; (4) ureter; (5) urinary bladder (6) urethra. <Br>'''Additional structures:''' (7) adrenal gland; (8) renal artery and vein; (9) inferior vena cava; (10) abdominal aorta; (11) common iliac artery and vein; (12) liver; (13) large intestine; (14) pelvis.]]
	[[File:Blausen 0592 KidneyAnatomy 01.png\|thumb\|Renal anatomy.]]		[[File:Blausen 0592 KidneyAnatomy 01.png\|thumb\|Renal anatomy.]]
	[[File:PMC5265200 13244 2016 536 Fig1 HTML.png\|thumb\|Perinephric space with exaggerated pararenal space to show retroperitoneal structures. Perinephric bridging septa are seen between the left kidney and the adjacent renal fascia.]]		[[File:PMC5265200 13244 2016 536 Fig1 HTML.png\|thumb\|Perinephric space with exaggerated pararenal space to show retroperitoneal structures. Perinephric bridging septa are seen between the left kidney and the adjacent renal fascia.]]

			===Upper Tract Injuries (kidney + ureter)===
	*Majority of blunt trauma injuries present with hematuria		*Majority of blunt trauma injuries present with hematuria
	*Renal pedicle injuries and penetrating injuries to ureter may not cause hematuria		*Renal pedicle injuries and penetrating injuries to ureter may not cause hematuria
	*Renal injuries are associated with flank hematoma, lower rib fracture, penetrating wounds to flanks		*Renal injuries are associated with flank hematoma, lower rib fracture, penetrating wounds to flanks

	===Evaluation===		===Lower Tract Injuries (bladder + urethra + genitalia)===
			*Often accompany [[pelvic fracture]]

			===Types===
			*[[Renal Injuries]]
			*[[Ureter Injuries]]

			==Clinical Features==


			==Differential Diagnosis==
			{{Abdominal trauma DDX}}
			{{Lower GU trauma DDX}}

			==Evaluation==
			===Workup===
	*Who to image?		*Who to image?
	**Penetrating Trauma		**Penetrating Trauma
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	**Note, CT A/P with IV contrast NOT sensitive enough for [[bladder trauma\|bladder rupture]], requires CT cystography		**Note, CT A/P with IV contrast NOT sensitive enough for [[bladder trauma\|bladder rupture]], requires CT cystography

	===~~Types~~===		===Diagnosis===
	*[[Renal Injuries]]
	*[[Ureter Injuries]]

	==~~Lower Tract Injuries (bladder + urethra + genitalia)~~==		==Management==
	*Often accompany [[pelvic fracture]]

	~~{{Lower GU trauma DDX}}~~

	==~~Differential Diagnosis~~==		==Disposition==
	~~{{Abdominal trauma DDX}}~~

	==See Also==		==See Also==
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	*[[Abdominal trauma]]		*[[Abdominal trauma]]
	*[[Trauma (main)]]		*[[Trauma (main)]]

			==External Links==

	==References==		==References==

Rossdonaldson1: /* Lower Tract Injuries (bladder + urethra + genitalia) */

2022-08-03T19:33:44Z

Lower Tract Injuries (bladder + urethra + genitalia)

← Revisión anterior		Revisión del 19:33 3 ago 2022
Línea 30:		Línea 30:

	==Lower Tract Injuries (bladder + urethra + genitalia)==		==Lower Tract Injuries (bladder + urethra + genitalia)==
	*Often accompany pelvic fracture		*Often accompany [[pelvic fracture]]

	{{Lower GU trauma DDX}}		{{Lower GU trauma DDX}}

Rossdonaldson1: /* Upper Tract Injuries (kidney + ureter) */

2021-03-17T21:15:31Z

Upper Tract Injuries (kidney + ureter)

← Revisión anterior		Revisión del 21:15 17 mar 2021
Línea 1:		Línea 1:
	==Upper Tract Injuries (kidney + ureter)==		==Upper Tract Injuries (kidney + ureter)==
			[[File:Urinary system.png\|thumb\|'''(1) Human urinary system:''' (2) kidney; (3) renal pelvis; (4) ureter; (5) urinary bladder (6) urethra. <Br>'''Additional structures:''' (7) adrenal gland; (8) renal artery and vein; (9) inferior vena cava; (10) abdominal aorta; (11) common iliac artery and vein; (12) liver; (13) large intestine; (14) pelvis.]]
			[[File:Blausen 0592 KidneyAnatomy 01.png\|thumb\|Renal anatomy.]]
			[[File:PMC5265200 13244 2016 536 Fig1 HTML.png\|thumb\|Perinephric space with exaggerated pararenal space to show retroperitoneal structures. Perinephric bridging septa are seen between the left kidney and the adjacent renal fascia.]]
	*Majority of blunt trauma injuries present with hematuria		*Majority of blunt trauma injuries present with hematuria
	*Renal pedicle injuries and penetrating injuries to ureter may not cause hematuria		*Renal pedicle injuries and penetrating injuries to ureter may not cause hematuria

SuperD: /* Evaluation */

2020-01-09T04:06:34Z

Evaluation

← Revisión anterior		Revisión del 04:06 9 ene 2020
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	**Blunt Trauma		**Blunt Trauma
	***Gross hematuria		***Gross hematuria
	***[[Hypotension]]and any degree of hematuria		***[[Hypotension]] and any degree of hematuria
	***Child with >50rbc/HPF		***Child with >50rbc/HPF
	***High index of suspicion for renal trauma		***High index of suspicion for renal trauma