title: Traumatic hematuria in children can be evaluated as in adults.
abstract: OBJECTIVE
  Controversy exists regarding whether children who present with blunt abdominal trauma and microhematuria should undergo renal imaging. Adult blunt trauma victims who present without gross hematuria, shock, or significant deceleration or other major associated injuries do not require renal imaging. This study was designed to evaluate whether the criteria for imaging the renal parenchyma in adult blunt trauma victims apply to the pediatric population.
  
  
  METHODS
  We retrospectively reviewed 720 consecutive pediatric patients with suspected renal trauma to determine mechanism of injury, evaluation and treatment of subsequent injuries.
  
  
  RESULTS
  Of the 720 trauma patients with hematuria (mean age 8 years) 334 underwent imaging, and 59 renal injuries were identified (grade I 32, grade II 6, grade III 8, grade IV 12, grade V 1). A total of 11 patients underwent exploration, resulting in 3 nephrectomies (grade IV 2, grade V 1). Renorrhaphy was not necessary and all other cases were managed conservatively. All patients with significant renal injuries experienced either gross hematuria, shock (systolic blood pressure less than 90 mm Hg) or a significant deceleration injury.
  
  
  CONCLUSIONS
  The decision to image pediatric trauma cases based on the adult criteria of gross hematuria, shock and significant deceleration injury is appropriate. Among 720 pediatric cases of potential renal injury all would have been identified.
authors.affiliation: Department of Urology, Wayne State University School of Medicine, Detroit, Michigan 48201, USA. rsantucc@med.wayne.edu
authors.forename: Richard A
authors.initials: RA
authors.lastname: Santucci
authors.forename: Scott E
authors.initials: SE
authors.lastname: Langenburg
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Zachareas
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006417:Hematuria / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007668:Kidney / Q000293:injuries*; D008297:Male; D012189:Retrospective Studies; D014949:Wounds, Nonpenetrating / Q000150:complications*