Differentiating between the lacerated kidney and the contused kidney requires IVP examination or CT scan. If a contrast study such as an aortogram is required for another reason, the kidneys can be assessed during the course of that study. A non-visualizing kidney implies severe rupture or avulsion of the renal pedicle. The contused kidney is simply observed. Some kidney lacerations can be managed non-operatively.
Surgical consultation is mandatory for any kidney that shows extravasation of dye.
Most commonly, injuries that break the wall of the bowel are due to penetrating injury. In penetrating trauma, the small bowel is most frequently injured, followed by the stomach and large intestine. Rupture also can occur when a localized crush occurs, such as when the steering wheel pinches the duodenum against the spine. In blunt trauma, most commonly the duodenum is injured, due to its location and its ligamentous attachments. Symptoms are caused by the intestinal contents, rather than blood loss.