Kidney fracture with active extravasation…

This patient came in shortly after a high speed motor-vehicle collision.  Here is the patient’s CT abdomen with IV contrast:

Kidney fx 3Kidney Fx 2Kidney fx 1

This is an interesting CT as it demonstrates “active extravasation” of IV contrast.  The patient has a large left kidney fracture.  You can see a hematoma surrounding the area where you would expect the kidney.  In that hematoma there is a mix of low attenuation material and high attenuation material.  Both of these represent blood; the high attenuation is contrast material that leaking into the hematoma (some of the high attenuation includes perfusing kidney fragments but most of it is extravasating contrast).  The low attenuation is blood that collected before IV contrast administration.

Practically speaking, this means that there is active bleeding into this hematoma.  This is BAD and represents a large amount of bleeding that needs to be stopped.  The patient was actually relatively stable and was taken to interventional radiology where the offending lesion was embolized.

Author:  Russell Jones, MD

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EMREMS: Radiology in Emergency Medicine

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One Comment on “Kidney fracture with active extravasation…”

  1. Donkey Whisperer Farm Says:

    I am a survivor of an almost fatal motor vehicle accident while riding as a passenger when a semi truck hit me. One of the many life threatening injuries was a grade v kidney tear. This was very painful but thanks to the angels working at the trauma hospital my kidney seems to have healed. Scary stuff as pain and blood in urine is one of the side effects.


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