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There is non-enhancement of left kidney. There is abrupt non-enhancement of the left renal artery approximately 8mm from its origin - ? transection or dissection. There is contrast extravasation within the left anterior pararenal space, likely from a mesenteric artery. There is haematoma within the anterior pararenal and posterior pararenal spaces. There is a small amount of free fluid within the pelvis and in the right paracolic gutter. No gross bowel abnormality demonstrated. The liver, spleen, pancreas, adrenal glands and right kidney are unremarkable. Previous cholecystectomy noted. There is a oblique horizontal fracture through the right pedicle of L2, which extends into the right lamina and spinous process and anteriorly to involve the right posteroinferior corner of the L2 vertebral body. Subcutaneous fat stranding noted in the left flank region.
Conclusion Left renal artery devascularisation, secondary to either dissection or transection of the left renal artery. Active bleeding in the left anterior pararenal space - bleeding vessel unclear from CT (likely mesenteric artery). T12 and L2 vertebral fractures.