Authors: Helen Blackhurst / Editor: Jason M Kendall / Reviewer: Mehdi Teeli / Codes: ACCS LO 2, SLO3, SuP1, TP5, UP5, UP6Published: 19/03/2021

A 37-year-old man is brought into the emergency department following a road traffic collision. He was the driver of a mini, which spun off the road, hit a tree and rolled into a ditch. He was trapped in the car for 90 minutes and had to be cut out by the emergency services. On examination he is conscious. His primary survey is normal. He is complaining of right-sided abdominal pain. There is evidence of bruising over the right flank, his abdomen is soft, bowel sounds are present, and he is tender over the area of bruising.

He undergoes CT abdomen as part of his initial assessment:

renalhaematoma

CT shows a right perinephric haematoma. The patient has microscopic haematuria (3+ of blood on urine dipstick testing).