Penetrating chest and abdominal injuries

Case contributed by Dr Heather Pascoe

Presentation

Stab to left posterior chest.

Patient Data

Age: 70
Gender: Male
CT

Chest, Abdomen and Pelvis

Chest:

  • Left sided hemothorax. No pneumothorax or rib fractures.
  • Left posterolateral chest wall hematoma with a focus of active bleeding.

Abdomen/Pelvis

  • Splenic laceration (AAST Grade III) with a focus of active bleeding inferomedially. 
  • Perisplenic hematoma.
  • Incidental anterior splenic calcified granuloma.
  • Small volume free fluid adjacent to the descending colon. No evidence of a laceration or hematoma.

Given the pattern of injuries, traumatic injury to the diaphragm is also present.

Case Discussion

When describing a splenic injury, it is important to describe the location (parenchymal vs subcapsular), the size of the hematoma or laceration and associated complications. Other findings to check for include active bleeding and pseudoaneurysm or arteriovenous fistula formation. 

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Case information

rID: 32883
Published: 9th Feb 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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