​Surgery Definition – what investigations should be performed in suspected upper urinary tract trauma?

​Surgery Definition – what investigations should be performed in suspected upper urinary tract trauma?
In cases where upper urinary tract trauma is suspected, the common investigations needed may include intravenous urography, renal ultrasonography, CT scanning and selective renal arteriography. Intravenous urography is performed after performing preliminary control kidney, urinary and bladder. The common abnormalities detected by intravenous urography are loss of psoas shadow, loss of renal outline and fracture of the ribs. This is followed later by iv contrast with a series of film and monitor the excretion. Comparison with contralateral non injured side is considered. There may be disruption of the pericaliceal, absence of the caliceal system or extravasation of the dye. 

Renal ultrasonography is transportable and can be used to detect any peri renal collections,intra renal hematoma, subcapsular hematoma and disruption of the parenchymal. CT scan may provide a similar result as above but patient need to be stabilized first. Selective renal arteriography is only considered in cases of macroscopic hematuria for more than one week.