Presentation
High speed motorbike accident.
Patient Data
Age: 50 years
Gender: Male
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Chest
- Small volume hematoma around the posterior aspect of the thoracic descending aorta spanning T6 to T11. This is likely tracking from the thoracic spine fractures.
- No acute rib or sternal fracture.
Abdomen and Pelvis
- Small volume locules of gas between the 7-10 intercostal spaces and the diaphragm.
- No free fluid or traumatic visceral injury.
Thoracic and Lumbar Spine
Transitional lumbosacral anatomy present with lumbarization of the first sacral segment. When counting from skull base there are 7 cervical, 12 thoracic and 6 lumbar type vertebra. The following fractures have been labeled from skull base:
- T1 right traverse process fracture at the tip.
- T6-T11 anterosuperior plate fracture with up to 25% height loss.
- T7 spinous process fracture.
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Zoomed key images.
Case Discussion
Small volume right-sided gas between the diaphragm and lower anterolateral intercostal spaces is benign posttraumatic pseudopneumoperitoneum due to vacuum phenomenon from traumatic impact.