Splenic trauma (grade IV)
Blunt left upper quadrant trauma at football. Positive FAST scan.
CT Abdomen and pelvis
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There is no obvious active bleeding on arterial phase. Large volume of haemoperitoneum through the abdomen and pelvic recesses. There are numerous full-thickness lacerations through the splenic substance. The lacerations involve the mid and posterior part of the spleen crossing multiple segmental vessels. No active bleeding or contrast pooling on portal vein phase imaging. The liver and gallbladder are normal. Normal adrenals, kidneys, and pancreas. No small bowel dilatation. No free air. No evidence for large bowel injury. No lymphadenopathy. Normal urinary bladder. No skeletal abnormality. The lung bases and pleural spaces are normal.
2 case question available
This patient was treated with endovascular splenic artery embolisation with a good clinical response and has been discharged a few days later.