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Extensive splenic lacerations extending to the hilum with areas of devascularisation. No evidence of active bleeding or pseudo-aneurysm. There is extensive haemoperitoneum throughout the abdominopelvic cavity. Cholecystectomy clips are noted along with extrahepatic and first order intrahepatic duct dilatation. Liver is uninjured. Adrenal glands, kidneys and pancreas are uninjured. Bowel is unremarkable. Lung bases are clear. No bony injury identified.

Conclusion:

AAST grade IV splenic injury with extensive haemoperitoneum.