Traumatic mesenteric and splenic injuries

Case contributed by RMH Core Conditions

Presentation

High-speed MVA. Tender and bruised RUQ.

Patient Data

Age: 55 years
Gender: Female

Abdomen/Pelvis

CT

Moderate volume of free intraperitoneal fluid, particularly around the spleen which has a small hypodense and superficial cleft posteriorly, suspicious for grade I laceration.

Patchy fat stranding and fluid is seen within the small bowel mesentery, in the region of mesenteric vessels. Small foci of higher density are seen within the fat stranding, immediately adjacent to vessels and suspicious for venous bleeding. The bowel loops themselves show no gross abnormality and there is no free gas.

Lap belt subcutaneous bruising overlies the epicenter of the mesenteric abnormality.

Case Discussion

Injuries demonstrated in this case:

  • mesenteric tear with (probable) active venous bleeding
  • grade 1 splenic laceration

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