title: The utility of initial and follow-up ultrasound reevaluation for blunt renal trauma in children and adolescents.
abstract: OBJECTIVE
  To discover if renal ultrasound (RUS) can be utilized as the primary follow-up imaging modality in the management of blunt renal injuries in children and adolescents.
  
  
  METHODS
  We initiated a protocol utilizing RUS reevaluations for children and adolescents treated for blunt renal injuries. Patients following this protocol (Post) had initial computerized tomography (CT) with RUS reevaluation at day 2 and 2 weeks. We retrospectively compared this group to a 2-year cohort treated between 2007 and 2009 (Pre).
  
  
  RESULTS
  In our study, 28 Post protocol patients were retrospectively compared with 22 Pre cohort patients. No significant differences were observed in age, length of stay (LOS), injury severity score (ISS), and utilization of CT reevaluation. Follow-up reevaluation was obtained in 13 Pre patients versus 21 Post patients (p = 0.231). No patients had any evidence of long-term complications in either cohort.
  
  
  CONCLUSIONS
  Our results suggest that RUS can be utilized as the primary surveillance imaging modality in the management of blunt renal injuries in children and adolescents. The lack of benefit of usage of RUS demonstrated in the acute post-injury surveillance period calls into question the benefit of RUS immediately following the blunt trauma.
authors.affiliation: Division of Pediatric Urology, Arkansas Children's Hospital, Little Rock, AR, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Canon
authors.affiliation: Division of Surgery, Arkansas Children's Hospital, Little Rock, AR, USA.
authors.forename: John
authors.initials: J
authors.lastname: Recicar
authors.affiliation: University of Arkansas for Medical Sciences, College of Medicine, 4301 W. Markham, Little Rock, AR 72205, USA. Electronic address: bhead@uams.edu.
authors.forename: Bryan
authors.initials: B
authors.lastname: Head
authors.affiliation: Division of Radiology, Arkansas Children's Hospital, Little Rock, AR, USA.
authors.forename: Leann
authors.initials: L
authors.lastname: Linam
authors.affiliation: Division of Surgery, Arkansas Children's Hospital, Little Rock, AR, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Swearingen
authors.affiliation: Division of Surgery, Arkansas Children's Hospital, Little Rock, AR, USA.
authors.forename: Todd
authors.initials: T
authors.lastname: Maxson
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D007668:Kidney / Q000000981:diagnostic imaging* / Q000293:injuries*; D007902:Length of Stay; D008297:Male; D017063:Outcome Assessment, Health Care; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000628:therapy
keywords: Expectant management; Traumatic renal injury; Ultrasound