Splenic injury (grade III with active bleeding)
Middle aged woman with increased abdominal pain. History of blunt abdominal trauma few days ago. No past medical history.
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Contrast-enhanced CT shows hypodense splenic laceration within the superolateral aspect of spleen does not involve the hilum. There are hyperdense areas due to an intraparenchymal hematoma on non-contrast images. Arterial phase demonstrates focal areas of high attenuation in the splenic parenchyma due to active extravasation.
There is also hemorrhagic peritoneal free fluid (hemoperitoneum).
Findings consistent with grade 3 splenic injury.
The spleen is the intra-abdominal organ most often injured as a result of blunt trauma.
The spleen is the most vascular organ, for this reason, a splenic injury is potentially life-threatening.
On arterial phase, CT images bright white “blush” or amorphous collection within a hypodense injured solid organ indicates active bleeding. When lacerations extend through the organ capsule, hemoperitoneum results; if the capsule is intact, a subcapsular hematoma may be demonstrated.