Splenic lacerations without evidence of active contrast extravasation. Haematoma surrounds the spleen and a small volume of blood tracks down to the left paracolic gutter. There is no hepatic injury.
Tear of the medial inferior aspect of the right rectus abdominis muscle with subcutaneous gas present. There is extraperitoneal blood tracking from the muscular tear inferiorly into the pelvis.
No other solid abdominal organ injury. Large and small bowel have a normal appearance.
Lumbar spine alignment is satisfactory.
Complex fracture of the sacrum with a vertical fracture line extending through the left aspect of the S2/S3 junction and tracking inferiorly through the sacral canal and involving the coccyx.
Nondisplaced fractures of the right acetabulum and both ischial bones inferiorly. There is a minor widening of the left sacroiliac joint and minor diastasis of the pubic symphysis.
There is associated haematoma within the pelvic sidewalls bilaterally that compresses the bladder, right more than left and in the presacral space. Free gas and haematoma track through the medial groins and there is the appearance of a traumatic haematocele on left.
Comminuted distal radius fracture without articular extension. No ulnar fracture. The carpal bones appear normal.
IMPRESSION
- Grade 3 splenic injury without active contrast extravasation.
- Complex fractures involving the sacrum and coccyx.
- Widening of the left sacroiliac joint and pubic symphysis.
- Nondisplaced fractures through the ischial bones bilaterally and the right acetabulum.
- Soft tissue haematoma in a straddle injury pattern as well as likely haematocele, and testicular injury require evaluation with ultrasound.
- Traumatic tear of the right rectus abdominis muscle and suspected right conjoint tendon injury
- Right distal radial fracture.