TVTRAUMAVAULTCASE-BASED TRAUMA JUDGMENT
Teaching image withheldThe image will be revealed when it becomes clinically available in the case.
Diagnostic contrast-enhanced axial CT of the abdomen showing a severely disrupted right kidney with extensive perirenal hematoma and active contrast extravasation, consistent with a grade V renal injury; the left kidney enhances normally. teaching visual
Diagnostic contrast-enhanced axial CT of the abdomen showing a severely disrupted right kidney with extensive perirenal hematoma and active contrast extravasation, consistent with a grade V renal injury; the left kidney enhances normally. • TEACHING IMAGE
Blunt genitourinary traumaHigh-energy blunt abdominal and flank trauma after a motorcyclist is thrown from his bikeAdvanced

Transiently Stable Motorcyclist With Grade V Renal Trauma

SCENARIO

A motorcyclist is thrown from his bike at high speed. He arrives immobilized with right flank and abdominal pain, abrasions, and no obvious external hemorrhage. Initial airway and breathing assessments are reassuring. After warmed blood products and limited crystalloid, his systolic blood pressure is approximately 110 mmHg, heart rate 118/min, and mental status is normal. Pelvic stability is maintained, and there is no clinical evidence of tension pneumothorax. Because he remains sufficiently responsive to resuscitation, a contrast-enhanced trauma CT is obtained. The uploaded CT image becomes available for review after acquisition. Immediately after leaving the scanner, he becomes pale and confused, and his systolic blood pressure falls to 60 mmHg.

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