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Large amount of high density intraperitoneal free fluid is consistent with haemoperitoneum, significantly increased in size since previous study.
Multiple hypodensities within the spleen consistent with lacerations have increased in size. There is a large 3 cm hypodense mass within the anterior part of the spleen producing local mass effect with bulging of the anteromedial capsule. This may represent a false aneurysm. Multifocal curvilinear enhancing foci within the spleen may represent contrast extravasation (most likely venous), as well as possible AV fistulae.
The inferior vena cava is partially collapsed and the portal vein is reduced in diameter since previous study, suggesting hypovolaemia.
Large amount of haemoperitoneum has accumulated since previous study.
The most likely origin is from the extensive splenic lacerations, with a possible newly formed splenic false aneurysm and AV fistula.