Hilar liver laceration and subcapsular renal haematoma

Case contributed by RMH Core Conditions

Presentation

High speed MVA. Tachycardic.

Patient Data

Age: 27
Gender: Female

Hypodensity is identified at the liver hilum, straddling the portal vein bifurcation, and on the left, extending to the ligamentum teres. The main, left and right portal veins are opacified normally.

Further subtle rounded, subcapsular low density within liver segment IVb is separate from the hilum.

8 - 9mm subcapsular haematoma within the lateral aspect of the right kidney, without a focal, visible underlying renal laceration.

L2 vertebral body crush fracture, with loss of approximately 20% anterior vertebral body height, without appreciable bony retropulsion. Fractures involve the right anterosuperior and left posteroinferior corners. Associated scoliosis convex to the left centered at L2. Non-displaced left L3 transverse process fracture. No further vertebral fracture identified.

Seatbelt distribution subcutaneous fat stranding.

Conclusion:

  • Liver hilar laceration and right subcapsular renal haematoma.
  • L2 vertebral body crush fracture. Left L3 transverse process fracture. 

Annotated images. 

Case Discussion

This case demonstrates a typical injury distribution associated with high-force blunt trauma:

  • subcutaneous fat stranding in a seatbelt distribution (seatbelt sign)
  • solid organ injuries
  • lumbar spine fractures
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Case information

rID: 32077
Case created: 12th Nov 2014
Last edited: 4th Jul 2017
Tag: trauma
Inclusion in quiz mode: Included

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