Which finding would most strongly suggest a renal injury after blunt abdominal trauma?

• A. Abdominal distention
• B. Flank hematoma
• C. Dyspnea
• D. Nausea

Answer: (B)

The key idea is recognizing signs that point to bleeding from a retroperitoneal organ, like the kidneys, after blunt trauma. The kidneys lie behind the peritoneum, so bleeding from a renal injury often shows up as bruising in the flank area. A flank hematoma directly indicates retroperitoneal blood loss near the kidneys, making renal injury the most likely among the options.

Other signs listed are non-specific. Abdominal distention can come from many causes, not just kidney injury. Dyspnea and nausea are general symptoms that don’t specifically alert you to renal damage. While hematuria would also support a renal injury, the flank hematoma is the strongest clue from this set.