Subcapsular liver hematoma
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High speed motor vehicle collision; ejected from vehicle.
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Liver (segment 7) subcapsular area, measuring 6 mm in depth. It has HU density of 55, in keeping with hematoma. No overlying rib fracture.
There is also a linear laceration extending into the parenchyma of segment IV. No intraparenchymal hematoma. No active bleeding.
Minimal free fluid in the pouch of Douglas.
The spleen, kidneys (apart from right superior pole cortical scar), pancreas, duodenum, GB/bile ducts adrenals have normal appearances.
The pelvic organs are normal. Bladder catheter. No free gas.
This is an example of an AAST Grade 1 liver injury involving the right hepatic lobe - it is small (< 10% of liver) and shallow (< 1 cm).
There is also a grade II laceration of segment 4 which at first glance could be mistaken for a normal hepatic fissure since there is no hematoma around it.
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