Complex polytrauma with multiple injuries described. Notice how each of the window/level settings helps you to identify the variety of injuries. 

At surgery, they confirmed the following:

• crush injury of the transverse colon
• complex duodenal injury along its entire length with necrosis; transection at the ligament of Treitz
• pancreas head injury with avulsion from the duodenum
• infrarenal aortic dissection 

The patient underwent the following surgeries following this case:

Emergent surgery:

• repair of infrarenal aortic dissection with patch angioplasty
• segmental resection of transverse colon
• oversew of significant injury of segments 2 and 3 of the duodenum and transection at the ligament of Treitz
• pyloric exclusion 
• placement of periduodenal and peripancreatic drains due to pancreatic head injury and avulsion from the duodenum
• temporary abdominal closure 

Follow-up operation:

• abdominal washout
• completion right hemicolectomy with Ileocolic anastomosis
• Whipple procedure