Presentation
Roll-over motor vehicle collision.
Patient Data
In the liver, segment VIII irregular low density area measuring 4.5 x 4.0 x 2.9 cm in keeping with liver laceration (grade III). Moderate perihepatic free fluid in keeping with blood.
No splenic laceration. Minor perisplenic blood.
Subtle wedge-shaped perfusion defect in the right renal upper pole, consistent with segmental renal artery dissection.
Loops of thickened hyperemic small bowel, most likely secondary to "shock bowel" (due to hypovolemia).
Distended bladder. Moderate free pelvic and paracolic gutter fluid.
Case Discussion
Shock bowel is part of the CT hypoperfusion complex. Multiple abdominal organs can be affected by shock, including the adrenal glands, liver, spleen, and possibly the pancreas.