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No pneumothorax. Cardiomediastinal contour within normal limits. No mediastinal haematoma. No evidence of great vessel injury. Sternal irregularity was considered artifactual. No displaced rib fracture.
Significant free gas and fluid. Retroperitoneal gas also noted, in particular around the right kidney. Significant amount of abdominal wall subcutaneous gas also noted.
Left sided loops of small bowel are thickened and oedematous down to the level of ileum. This loop of the bowel appears disrupted at its distal aspect with no definite continuity to the rest of the bowel.
There is contrast pooling adjacent to the superior mesenteric artery and vein as well as a smaller amount inferior to it adjacent to the small mesenteric branches within the pelvis. There is also contrast blush adjacent to the distal descending colon. These indicate multiple areas of active bleeding within the extensive mesenteric haematoma.
Completely effaced IVC is indicative of extreme hypovolaemia.
Extensive intra-abdominal free fluid and gas, with areas of active bleeding as described. The appearance is suspicious for hollow viscus injury/perforation.