A broken kidney
A 17 year old man was brought in to the accident and emergency department in the early hours of the morning having sustained an obvious head injury. He had been found wanW, dering by the roadside, smelled of alcohol, was agitated, and could not remember what had happened. On examination, doctors found a small scalp laceration and right flank bruising. No focal neurological signs could be elicited and no major musculoskeletal injuries were detected on examination. However, a urine specimen showed the patient had frank haematuria (blood in the urine altering its colour to the naked eye).
The consultant radiologist arranged urgent contrast enhanced computed tomography of the abdomen.
Victims of polytrauma often suffer devastating injuries that take priority over possible renal injuries, which may not be immediately evident. The presence of loin pain bruising, lower rib fractures, and haematuria are suggestive of renal trauma. Haemodynamic changes such as hypotension