Puerperal sepsis

Enlarged (post parturition) uterus with heterogeneous enhancement and swelling in the myometrium and endometrium especially at the fundus suggestive of localized sepsis.  Full hand of CT hypotension complex ie "black spleen" with virtually no ehancement in arterial and portal venous phases (HU of 49 to 58), "shock pancreas" with patchy enhancement and oedema in the adjacent mesentery, "shock liver" with reduced enhancement and periportal oedema, "shock bowel" with dilatation and mural oedema with increased enhancement and "black kidneys" showing markedly reduced enhancement especially in the arterial phase.  Note the splenic and renal arteries are patent on the angiogram thus reduced parenchymal enhancement is at an arteriole/capillary level. Aorta and IVC are notnot collapsed or slit-like.