Presentation
History of recent blunt abdominal trauma with left flank pain and hematuria.
Patient Data
An 85 mm thick-walled subcapsular fluid collection is noted antero-inferior to the left kidney causing a pressure effect on the adjacent renal parenchyma. After contrast media administration the lesion shows no frank enhancement. Mild perinephric fat stranding is observed. On delayed post-contrast excretory phase no contrast leakage is noted within the lesion.
A small simple cortical cyst in the right kidney.
The mean attenuation value of the liver parenchyma is less than of the spleen on non-contrast images suggesting fatty liver.
Case Discussion
Regarding the history of blunt trauma and CT findings, a subcapsular perirenal hematoma is the main diagnosis that is a form of perirenal hematoma and accords grade I AAST kidney injury scale.
On CT images, a subcapsular perirenal hematoma is typically seen as a crescentic hematoma peripherally encapsulating a portion of the kidney. The attenuation value depends on the age of the hemorrhage.
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