Presentation CT - arterial and portal venous phase study
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Prominent perisplenic haematoma (sentinel clot) with marked liquid blood around the liver. Multiple splenic pseudoaneurysms with an associated traumatic A-V fistula characterised by early filling of the splenic vein on the arterial phase of the study. Note leak of contrast into the left subphrenic space indicating that there is active bleeding requiring urgent treatment (in this case splenectomy).