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A contrast blush is seen on the arterial phase images extending from the gastroduodenal artery into a round lobulated 8 x 5.1 x 4.2 cm soft tissue density along the dorsal aspect of the pylorus which demonstrates homogeneous enhancement on the delayed images. This is most in keeping with a gastroduodenal pseudoaneurysm which has likely developed following the abdominal trauma particularly in the setting of pancreatic lacerations. The pseudoaneurysm is closely related to the pancreatic neck with effacement of the neck. Heterogeneous material in the stomach and history of massive haematemesis in keeping with rupture of the pseudoaneurysm in to the pylorus however active extravasation from the pseudo-aneurysm into the stomach is not identified.
IVC filter in situ. The IVC and common iliac veins are collapsed.
Previous laparotomy with small bowel surgery with anastomotic sutures in the ilium.
Previous right sacral alar, iliac and bilateral pubic bone fractures noted. Evidence of previous pelvic fixation.
Bilateral lower lobe atelectasis.
8 cm gastroduodenal pseudoaneurysm.