Grade V liver laceration
Motor vehicle collision.
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No aortic injury. The pericardium is content of normal appearances. No pneumothorax or haemothorax. The central airways are patent.
Multiple liver lacerations are detected affecting most of the right liver. The lacerations extends to the hilum. There is active extravasation of contrast seen within segment five of the liver, related to the right anterior branch of the hepatic artery (or portal vein).
The liver lacerations are associated with a moderate amount of haemoperitoneum. Haemorrhage is seen around the right adrenal gland. The left adrenal gland is normal..
The right sixth, seventh, eighth, ninth rib fractured laterally.
2 case questions available
CT Trauma protocols vary from institution to institution but where CTA Thorax is followed by CT Abdomen/Pelvis in portal venous phase, it essentially gives a two-phase study of the upper abdomen, which is very useful in assessing for active bleeding. The upper abdomen should always be carefully examined on CTA Thorax.
This patient proceeded to angio-embolisation with particles, which was effective and haemostasis was achieved.