Paediatric Blunt Trauma and Microhaematuria

Cite this article as:
Taylan Gurgenci. Paediatric Blunt Trauma and Microhaematuria, Don't Forget the Bubbles, 2016. Available at:
https://doi.org/10.31440/DFTB.8785

Bottom line pearls:

  • Gross haematuria must be taken seriously as it raises the likelihood of finding significant renal pathology
  • Microhaematuria of any degree is most useful when serial urinalyses are performed.  Seeing a downward trend in the degree of microhaematuria is much more useful than the actual number.
  • The received wisdom suggesting a microhaematuria of 50RBC/HPF is the dividing line between trivial and significant haematuria is not supported by much evidence.
  • Microhaematuria in a child with a possible renal injury is best managed by serial examination, serial FBC, and serial urinalysis.  Discharge is safe if the examination remains stable, the FBC is stable, and the microhaematuria resolves.
  • There is no role for the urine dipstick in suspected renal injury.
  • Adult imaging protocols may be applied to paediatric blunt trauma though with some important provisos.