Stellate liver and right kidney lacerations

Case contributed by RMH Core Conditions

Presentation

High speed MVA

Patient Data

Age: 25 years
Gender: Female

Moderate haemoperitoneum with blood seen predominantly within the right upper quadrant tracking down the paracolic gutters and pooling within the pelvis with the presence of clot formation.

Stellate right lobe hepatic laceration with intraparenchymal haematoma. The left lobe of the liver is spared. The main portal vein and branches are intact. There is mild evidence of periportal tracking. No active contrast extravasation. No pseudo-aneurysms seen.

The right kidney is heterogenous in appearance with evidence of a parenchymal defect extending through the cortex to the medulla. There is a focal region within the mid to lower pole suspicious for segmental infarction. The main renal artery is patent. There is no change in calibre lateral renal artery enhancement to suggest renal artery dissection.

The gallbladder is distended. The pancreas, spleen and adrenal glands also appear preserved. There is no free gas to suggest the presence of a viscus injury. Presumed gastric paresis noted.

The bladder is moderately distended but intact. Flattening of the IVC is in keeping with a moderate degree of hypovolaemia.

No pelvic fracture identified.

 

Case Discussion

Injuries sustained:

  • liver laceration (AAST grade 3)
  • renal laceration (AAST grade 3)
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Case information

rID: 28596
Case created: 1st Apr 2014
Last edited: 11th Oct 2017
Tag: trauma
Inclusion in quiz mode: Included

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