Shattered spleen - AAST grade V injury

Discussion:

The spleen is 'shattered' into pieces, with active contrast extravasation at the splenic hilum, which extends across the midline towards the hepatic hilum.

High attenuation fluid in the upper abdomen and pelvis in keeping with hemoperitoneum.

This is the highest grade splenic injury (grade 5).

The patient proceeded to an emergency splenectomy, which confirmed the above, including 1.5 liters of blood in the peritoneum, and a bleeding vessel at the splenic hilum.

The concomitant left renal laceration managed conservatively.

Life lesson: motorbikes and alcohol are not sensible friends.

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