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CT of adult urinary tract trauma

Department of Radiology, St James's University Hospital, Beckett Street, Leeds LS9 7TF, UK

• CT is the first line investigation for evaluating haematuria following major abdominal trauma in adults.
  
• For renal trauma, intravenous urography (IVU) should be limited to centres without CT facilities. It may be used as a one-shot on table IVU in patients who are haemodynamically unstable and require immediate surgery.
  
• For ureteric trauma, there are no reliable clinical predictors. A high index of clinical suspicion is therefore required to ensure prompt exploratory laparotomy in order to assist accurate diagnosis and early surgical repair.
  
• For bladder trauma, CT cystography with retrograde filling is a valuable adjunct for the assessment of suspected bladder injury and should replace conventional cystography in the emergency setting.
  
• Renal arteriography with embolisation in preference to surgery is increasingly used to treat Grade 3 renal injury if the patient is stable.
  

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