Indications for intravenous pyelography in XXXX .

@entity1 @entity8 @entity1410 @entity1230 @entity158 @entity811 @entity130
The cornerstone for radiographic evaluation of genitourinary @entity130 is intravenous pyelography (IVP). Despite its widespread use, however, the indications for emergency IVP in @entity130 remain controversial. Some authors recommend the use of an IVP for all @entity1 with @entity811 , while others are selective, basing their decision on the degree of @entity811 or such other factors as the mechanism of injury, physical examination, or the presence of associated injuries. Based on the data reviewed for blunt and penetrating @entity130 , we recommend that an IVP be performed in: all @entity1 with gross @entity811 ; all @entity1 who present with @entity158 or tenderness that could be referrable to the genitourinary tract, even in the absence of @entity811 ; all @entity1 with flank @entity1410 or ecchymosis; and all @entity1 with penetrating @entity130 that could reasonably be expected to injure the genitourinary tract. Recently computed tomography (CT) has been proposed for the evaluation of renal @entity130 . The CT proponents cite superior definition of the extent of @entity8 and superior detection of injuries not clinically suspected. Some have proposed the following algorithm, incorporating computed tomography. If an isolated @entity8 is suspected clinically, an emergency IVP is performed. If the IVP is normal, expectant conservative treatment follows. If the IVP is abnormal or if the @entity1 has persistent symptoms, an emergency CT scan is performed. Furthermore computed tomography is performed initially in the stable @entity1 with @entity1230 and in the @entity1 with suspected severe @entity8 . While this algorithm has not been universally accepted, future studies confirming the theoretical advantages of this approach are anticipated.
