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Polytrauma with renal artery injury and active extravasation

Case contributed by Michael P Hartung
Diagnosis almost certain

Presentation

Trauma.

Patient Data

Age: 35 years
Gender: Male

Small right hemothorax. 

Right adrenal hematoma. 

Several right hepatic lobe lacerations. 

Injury of the right renal artery with active extravasation and a large amount of hemoretroperitoneum extending into pelvis/space of Retzius. Small areas of cortical hypoenhancement of the medial/upper cortex are likely infarcts.

Small amount of blood within the peritoneal cavity. 

Case Discussion

Polytrauma with a very large amount of retroperitoneal blood due to active bleeding from right renal artery. The blood products dissect into the pelvis and help to define the extraperitoneal space (space of Retzius), although some blood has also extending into the peritoneal cavity as well. This patient requires urgent surgical or endovascular intervention. 

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