Traumatic mesenteric and splenic injuries
High-speed MVA. Tender and bruised RUQ.
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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 epicentre of the mesenteric abnormality.
Injuries demonstrated in this case:
- mesenteric tear with (probable) active venous bleeding
- grade 1 splenic laceration