Pancreatic transection with liver, renal and colonic lacerations
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MVA 100kpm into tree. Thorax vs steering wheel. Open left femoral fracture. Tender abdomen.
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Branching hypodensity extending from the gallbladder fossa anteriorly is consistent with a liver laceration. This approaches the anterior surface of the liver. Fluid within the gallbladder fossa. No perihepatic hematoma.
Linear hypodensity at the superior pole of the right kidney likely represents a laceration. Fat stranding around the right kidney.
Fat stranding and fluid surrounding the splenic flexure. Two small adjacent gas locules appear extraluminal - there is surrounding fluid and soft tissue stranding and these may be intramural in location. No definite adjacent bowel wall thickening. The remainder of the large and small bowel are within normal limits.
The tail of the pancreas is irregular and is surrounded by free fluid. Hypodensity through the neck of the pancreas that appears to extend all the way through. The portal vein opacifies normally.
Free fluid adjacent to the spleen measures 10HU in keeping with simple free fluid. Free fluid within the pelvis - the density is higher in the more dependent regions. This may represent a combination of fluid +/- blood.
The spleen opacifies normally, with no evidence of contusion or laceration. The adrenals and bladder are unremarkable.
No lumbar vertebral fracture or malalignment. No paravertebral hematoma.
No fracture of the pelvis, sacrum or proximal femora. The sacroiliac joints and pubic symphysis are not widened.
- Right superior pole renal laceration with adjacent perinephric stranding.
- Fluid and stranding around the splenic flexure and small locule of gas (possibly extra luminal), raises the suspicion of splenic flexure injury (contained). There is no free intraperitoneal gas.
- Pancreatic body laceration, probably transection (pancreatic duct at high risk of injury).
- Liver laceration extending from the gallbladder fossa. No perihepatic hematoma.
- Free fluid in the pelvis - fluid +/- blood.
Transverse colon laceration confirmed at laparotomy.
20 public playlists include this case
- 31/08/2021 by elroy
- Australasian Trauma Society 2017 by Craig Hacking ◉ ◈
- Last day abdomen viva by PARTH ANUKUL NAIK
- Basic ER by Taimur
- QRTN Key conditions exam by Craig Hacking ◉ ◈
- abd ct by Marc Andres
- UQ Med Yr 2 Trunk trauma by Craig Hacking ◉ ◈
- kejsy #1 (part 15) by Lech Gradziński
- 2b GIT by Ali Labeeb Alwan
- Trauma by Gregory Makris
- ANZCA workshop 2017 by Craig Hacking ◉ ◈
- QRTN Key conditions exam with answers by Craig Hacking ◉ ◈
- UQ Radiology 'how to' series: Abdomen CT: Lung bases, soft tissues and bones by Craig Hacking ◉ ◈
- Trauma abdomen case examples for regs by Craig Hacking ◉ ◈
- UQ Radiology video tutorial: Abdo: Trauma by Craig Hacking ◉ ◈
- Imaging for Anaesthetics Registrars by Cara Odenthal
- Abdo viva by sanjay patel ◉
- ER (part 3) by Taimur
- Lastday Ranzcr before efilm by PARTH ANUKUL NAIK
- GI by Taimur