Liver and renal injury

Case contributed by Dr Hidayatullah Hamidi

Presentation

Blunt abdominal trauma

Patient Data

Age: 5 years
Gender: Male
CT

LIVER: Multiple deep linear branching hypodense lacerations are seen involving segments VI and VII of liver with associated large hypodense subcapsular parenchymal hematoma. No evidence of contrast blush or active bleeding. Intact vascular pedicle. 
Right kidney: No clear continuity of right renal artery in the middle portion with marked parenchymal hypodensity of the right kidney.

Right renal vein is well opacified and contrast feeding to the kidney through venous system is noted.

The VRT reconstructed image is from the venous system which shows well opacification of the venous system of the kidney likely backwards from the inferior vena cava. as no arterial supply is seen.

Moderate fluid in the peritoneal cavity which in context of trauma or more in favor of hemoperitoneum.
Spleen, left kidney, adrenals and pancreas are unremarkable.
Left side mild and right side minimal pleural effusion with underlying lung atelectatic .
Slightly displaced fracture of right iliac wing is noted.

Case Discussion

Liver injury grade III according to AAST grading scale.
Right renal injury grade V according to AAST grading scale.
Moderate hemoperitoneum.
Slightly displaced fracture of right iliac bone.

No further follow up available.

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Case information

rID: 82790
Published: 11th Oct 2020
Last edited: 12th Oct 2020
Inclusion in quiz mode: Included