Presentation
Abdominal pain following trauma.
Patient Data
NCCT abdomen shows several ill-defined, small areas of blood attenuation within the splenic parenchyma. Post-contrast study shows contrast extravasation within these areas with slight increase in size as well. The contrast "blush" does not follow the blood pool in the subsequent phases, suggesting active bleed confined to the splenic capsule.
There are multiple parenchymal lacerations, the largest measuring >3cm in length, with some of them involving the segmental vessels, producing >25% devascularization of the splenic parenchyma. Subcapsular hematoma involving >50% of splenic surface area.
Mild hemoperitoneum and minimal left pleural effusion.
Case Discussion
In this case, surgery confirmed multiple splenic parenchymal lacerations and active bleeding, suggesting AAST grade IV splenic injury. The patient underwent splenectomy.
Unable to process the form. Check for errors and try again.