FIGURE 108.3 Renal fracture Computed tomography section of the abdomen shows fracture of the left kidney with moderate subcapsular hematoma Angiography Angiography has been largely replaced by noninvasive modalities, especially in the pediatric patients in whom technical problems with vascular access result in a higher complication rate than in adults Arteriography does not add useful information to contrast CT scanning and may increase diagnostic delay during the preoperative workup It is however quite useful in patients who require therapeutic embolization of an active bleeding site (generally segmental artery or more distal) and may be considered as first-line therapy in such cases Nuclear Medicine Imaging and MRI Currently, there is no role for radionuclide imaging (DMSA, MAG3) or magnetic resonance imaging (MRI) in the acute setting for children with suspected renal trauma although there is a role in the follow-up evaluation of renal injury and long-term renal function Clinical Indications for Discharge or Admission