The significance of hematuria in children after blunt abdominal trauma.

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Abstract
The clinical significance of hematuria in children who sustain blunt abdominal trauma continues to be debated, as do the criteria for diagnostic imaging in this population. Previous reports have discussed the usefulness of certain clinical predictors of renal injury, such as the amount of hematuria present, the presence of shock or of head injury, and the presence or absence of symptoms or findings on physical examination. To assess the value of such predictors of renal injury in children with posttraumatic hematuria, we reviewed and analyzed the medical records and abdominal CT examinations of 256 children with blunt abdominal trauma. One hundred six children (41%) had hematuria. Thirty-five patients (14%) had renal injury that could be diagnosed by using CT. Nine of these had clinically significant injuries according to our criteria. We found a direct relationship between the amount of hematuria and the severity of renal injury. Hypotension at presentation occurred in 38 patients and was an insensitive ...

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