Traumatic rib fractures, pneumothorax and liver laceration

Case contributed by Dr Vikas Shah

Presentation

Driver of car involved in road traffic collision. Chest pain.

Patient Data

Age: 40 years
Gender: Male

Shallow apical right pneumothorax. Small right pleural effusion, in the context of trauma this is likely to be a haemothorax. No definite rib fractures.

Trauma protocol CT

Modality: CT

Shallow right pneumothorax and pleural effusion. Fractures of right 10th, 11th and 12th ribs but no flail segment. Collapse of part of right lower lobe with cystic spaces within lung representing lung lacerations.

Branching low attenuation in liver extending from gallbladder fossa to segment V representing laceration/parenchymal haematoma. Similar but smaller area adjacent to falciform ligament.

No signs of renal or bowel injury.

Case Discussion

The liver injury was classified as grade II on the American Association for the Surgery of Trauma (AAST) liver injury scale (laceration <10cm in length). There is an association between liver injury and other right sided traumatic findings such as rib fractures, lung injury, pneumothorax, renal and adrenal injuries.

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Case Information

rID: 52037
Case created: 18th Mar 2017
Last edited: 21st Mar 2017
Inclusion in quiz mode: Included

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