Mesenteric injury with hematoma

Case contributed by Dr Dayu Gai

Presentation

This 35 year old male was involved in a high speed motor vehicle accident. A CT trauma series was performed.

Patient Data

Age: 35 years
Gender: Male

Conclusion:

  • Mesenteric injury with intraperitoneal hematoma, with associated hyperdense sentinel clot
  • Extensive homogeneous intraperitoneal free fluid
  • Splenic laceration
  • No intracranial, cervical spine or intrathoracic injury evident

Case Discussion

Mesenteric injury often results from compression and deceleration forces causing injury to the mesenteric plexus1. Note the hyperdense fluid surrounding the bowel, and tracking in between the mesenteric fat. The sentinel clot sign can be used to localize the source of occult hemorrhage in trauma.

Case contributed by A/Prof. Pramit Phal.

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