The spleen has markedly increased in size and has become heterogeneous and demonstrates an irregular contour. The enhancing splenic parenchyma appears to be medial, with a large amount of heterogeneous subcapsular haematoma that is mainly lateral, with fluid-fluid levels. Extensive intra-abdominal and pelvic free fluid/blood with clot.
The liver, adrenal glands and pancreas appear normal. No cholelithiasis. Likely incidental small cysts within the kidneys. Flattened and volume-depleted inferior vena cava. Mildly displaced and comminuted inferior and superior pubic ramus fracture and minimally displaced right sacral alar fracture, similar compared with previous scan. Intra medullary nail in the left proximal femur. IDC in situ. Small left-sided pleural effusion and associated with some dependent change and consolidation in the left lung base has developed.
Conclusion
Large subcapsular and intraperitoneal splenic haemorrhage with evidence of hypovolemia.