Mesenteric haematoma from penetrating trauma

Case contributed by RMH Core Conditions

Presentation

Stabbing. Free fluid around liver on FAST.

Patient Data

Age: 32
Gender: Female
Modality: CT

Moderate haemoperitoneum as well as large mesenteric haemorrhage. No definite area of active contrast extravasation.

Small pneumoperitoneum suggesting bowel wall perforation, probably involving the transverse colon. Marked faecal loading and distended colon, transverse colon measuring 5.5cm.

No solid organ injury identified. Collapsed IVC in keeping with hypovolaemia. Dependent atelectasis in the lung bases.

Modality: Annotated image

Red arrows indicate position of mesenteric haematoma. 

Case Discussion

FAST scans are well established in trauma centres, having replaced diagnostic peritoneal lavage for assessment of haemoperitoneum. Studies have shown relatively high sensitivity (~90%) and specificity (~95%) but this will obviously depend on operator training and experience. 

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Case Information

rID: 32076
Case created: 12th Nov 2014
Last edited: 26th Nov 2016
Tag: trauma
Inclusion in quiz mode: Included

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