Extrapleural fat sign

Case contributed by Dr Yair Glick

Presentation

Fall from height

Patient Data

Age: 55 years
Gender: Male
Modality: CT

Total body CT done. Full chest scanned at arterial phase and delayed phase (shown).

Deflated balloon catheter in aorta (right femoral approach), tip at proximal end of descending aorta. Well-placed endotracheal tube and nasogastric tube. Pleural drain on each side, end-holes blocked, resultant soft tissue emphysema.
Small bilateral pneumothorax. Bilateral pleural effusion (haemothorax), small amount on right and moderate on left, with passive subpleural atelectasis at lung bases.
Visible extrapleural fat stripe on left denotes extrapleural hematoma as well (extrapleural fat sign).
Thoracic aorta preserved.
Periaortic hematoma extending from T2 to T9. Within it, left paravetebral focus of contrast material extravasation - arterial hemorrhage, perhaps from vertebral artery.

Fracture at lateral third of left clavicle.
Burst fracture, T3 and T4 vertebrae, retropulsion at T4 level, exerting pressure on thecal sac. Fracture, left transverse process of T3.
Fracture, right ribs 1, 2, 4, 5, and 8; left ribs 5-7.

Haematoma in intrinsic muscles of back, extending between T2-T4, with contrast material extravasation not seen on arterial phase - venous haemorrhage most probably.

Small amount of free intraeritoneal fluid, likely from diagnostic peritoneal lavage (DPL) done immediately prior to scan.

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Case Information

rID: 51856
Case created: 10th Mar 2017
Last edited: 21st Apr 2017
Systems: Chest, Trauma
Inclusion in quiz mode: Excluded

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