case_images: PMC10162895_01
case_images: evaluation and clinical findings in the first patient A) initial CT scan showed viable upper, middle, and lower renal pole with intact contralateral kidney: coronal view (upper), axial view (lower); B, C) CT scan evaluation, intact vascular pedicle (upper), intact pelvicalyceal system (lower)
case_images: PAMJ-44-71-g001.jpg
case_images: PMC10162895_01_PAMJ-44-71-g001.jpg
case_images: F1
case_images: Intravenous contrast-enhanced abdominal computer tomography (CT) scan showed isolated grade V renal injury with discontinuity of upper renal pole and intact vascular pedicle, and large hematoma (Figure 1A). At three months of follow-up, the patient had a good clinical condition, and CT scan showed the resolve of renal damage without extravasation (Figure 1B).
case_images: PMC10162895_02
case_images: evaluation and clinical findings in the second patient A) initial CT scan showed right kidney laceration involving the pelvicalyceal system, segmental artery injury with leakage of urine in perirenal: coronal view (upper), axial view (lower); B) 1-week urgent CT scan evaluation, large urinoma in right kidney: coronal view (upper), axial view (lower); C) abdomen CT scan evaluation 1 month after to urinoma drainage (upper), RPG evaluation during DJ Stent removal (lower)
case_images: PAMJ-44-71-g002.jpg
case_images: PMC10162895_02_PAMJ-44-71-g002.jpg
case_images: F2
case_images: Diagnostic confirmation using an abdomen CT scan with contrast was done (Figure 2A). One week after the procedure, evaluation using a contrast-enhanced abdominal CT scan showed a large urinoma in the retroperitoneal space of the right kidney (Figure 2B). At three months of follow-up, the patient had a good clinical condition, and the CT scan showed the resolve of renal damage without extravasation (Figure 2C).
case_images: PMC10162895_03
case_images: evaluation and clinical findings in the third patient A) initial CT scan showed laceration of left kidney with a form of shattered kidney: coronal view (upper), axial view (lower); B) 1-week urgent CT scan evaluation left kidney hematoma with a decrease of renal function secretion was found without any active bleeding and leakage: coronal view (upper), axial view (lower); C) super selective embolization; D) abdomen CT scan evaluation 1 month after drainage of hematoma and embolization (upper), RPG evaluation during DJ stent removal (Lower)
case_images: PAMJ-44-71-g003.jpg
case_images: PMC10162895_03_PAMJ-44-71-g003.jpg
case_images: F3
case_images: From the abdomen CT scan with contrast, we found a laceration of the left renal with formed of shattered renal and classified as high-grade renal trauma AAST grade V (Figure 3A), and NOM was performed as treatment. One week after the procedure, evaluation using a contrast-enhanced abdominal CT scan showed a large urinoma in the retroperitoneal space (Figure 3B) that needed urinoma drainage and DJ stent insertion. Abdomen CT scan evaluation one month following drainage showed successful angiography procedure (Figure 3C). Follow-up three months later showed no sign extravasation and the result of CT images were normal (Figure 3D).