RESUMO
The cases of seven children treated from 1980 through 1991 with blunt renal artery injuries were reviewed to determine (1) if computed tomography alone could eliminate the need for intravenous pyelography (IVP) or arteriography (ART); and (2) the causes of management delays. The diagnosis of arterial occlusion was suggested by the lack of renal contrast enhancement in six patients with CT scans and in two patients with IVP. In three patients ART was merely confirmatory. The diagnosis was suggested by IVP or CT scan within a mean of 4.7 hours of injury, but ART added an additional mean 2.3 hours to the diagnostic workup. There was an additional 3.9-hour average delay in the operating room before revascularization. Six patients underwent revascularization. Four had minimal function by postoperative renal scans. Renal artery occlusion is rapidly detected by contrast-enhanced CT scanning without IVP or ART. The time period from diagnosis to revascularization must be expedited to improve renal outcome.
Assuntos
Rim/lesões , Obstrução da Artéria Renal/diagnóstico por imagem , Obstrução da Artéria Renal/cirurgia , Reperfusão/métodos , Estudos de Tempo e Movimento , Tomografia Computadorizada por Raios X , Ferimentos não Penetrantes/complicações , Angiografia , Criança , Pré-Escolar , Protocolos Clínicos , Eficiência Organizacional , Feminino , Hospitais Pediátricos , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde , Pennsylvania , Intensificação de Imagem Radiográfica , Obstrução da Artéria Renal/etiologia , Estudos Retrospectivos , Traumatologia , UrografiaRESUMO
A commitment to the maintenance of a comprehensive trauma registry can provide numerous benefits, both administrative and clinical. Uses of the information collected can vary in nature and scope based on the needs of the facility and the requirements of external regulatory bodies. Ultimately, the choice of data applications rests with the facility collecting the information. As the facility grows and evolves, so can--and must--its registry.