Presentation
Driver of car involved in road traffic collision. Chest pain.
Patient Data
Shallow apical right pneumothorax. Small right pleural effusion, in the context of trauma this is likely to be a hemothorax. No definite rib fractures.
Shallow right pneumothorax and pleural effusion. Fractures of right 10th, 11th and 12th ribs but no flail segment. Collapse of part of right lower lobe with cystic spaces within lung representing lung lacerations.
Branching low attenuation in liver extending from gallbladder fossa to segment V representing laceration/parenchymal hematoma. Similar but smaller area adjacent to falciform ligament.
No signs of renal or bowel injury.
Case Discussion
The liver injury was classified as grade II on the American Association for the Surgery of Trauma (AAST) liver injury scale (laceration <10cm in length). There is an association between liver injury and other right sided traumatic findings such as rib fractures, lung injury, pneumothorax, renal and adrenal injuries.
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