Traumatic hepatic and splenic lacerations

Case contributed by Dr Bruno Di Muzio

Presentation

MVA at 100km/h.

Patient Data

Age: 24-year-old

CT Chest, Abdomen, and pelvis

Modality: CT

Chest bilateral peripheral lower lobe contusions and pneumatocoeles, especially noted on the left. Pleural spaces are clear. Airways are normal. There is no mediastinal abnormality, the thoracic aorta has normal opacification and calibre, with no evidence of dissection, transection, or pseudoaneurysm. No mediastinal haematoma. No lymph node enlargement. Thoracic cage is preserved, with no evidence of fractures.

Liver laceration centred in the segments I and IVA with about 7 cm in depth associated with mild extension through the segment VIII. No contrast blush was seen. Subcapsular haematoma involving less than 50% of the liver surface. Portal vein, hepatic veins, and IVC are normally opacified. Laceration through the anterosuperior aspect of the spleen with surrounding hematoma.

Pancreas and kidneys are normal. The right adrenal gland is partially obscured by haematoma; the left gland is normal. No abnormality of the bowel is identified. There is no free gas. Haemoperitoneum along both parieto colic gutters and in the pelvis. No pelvic fractures.

Case Discussion

Patient involved in a high-speed motor vehicle accident with internal solid viscera contusions:

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Case Information

rID: 49373
Case created: 22nd Nov 2016
Last edited: 15th Dec 2016
Tag: rmh
Inclusion in quiz mode: Included

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