Splenic injury - AAST grade IV

Case contributed by RMH Core Conditions
Diagnosis certain

Presentation

Car vs. car collision 60km/hr. Positive FAST - fluid around liver.

Patient Data

Age: 20 years
Gender: Male

Moderate volume of hemoperitoneum. Multiple splenic lacerations extending to the hilum with evidence of active contrast extravasation. 

Periportal low attenuation within the liver in keeping with fluid resuscitation.

The remainder of the abdominal and pelvic organs are within normal limits. No pelvic bone fracture. No fracture or dislocation.

Case Discussion

FAST scans are performed by point-of-care providers (normally emergency physicians) and are used as a decision-making aid about the need for an emergent trauma laparotomy. 

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