Why is it important to report the presence of a tampon in situ?
The presence of a tampon is important to identify because it can be a source of sepsis if retained for some time, e.g. in ICU whilst the patient is intubated.
Why is it important to report if there is injury to the pancreatic duct?
If the pancreatic duct is disrupted treatment is surgical or endoscopic with stent placement. The pancreatic duct cannot always be directly imaged with CT, but duct disruption can be suggested based on the extent of the parenchymal laceration. If the depth of the laceration is less than 50% there is a decreased risk of main pancreatic duct involvement.
- Small right haemothorax.
- Tiny pneumomediastinum
- Fractures of the right T7-T9 transverse processes
- Fracture through the right posterolateral superior corner of the T10 vertebral body.
- Devascularisation of the left kidney secondary to dissection of the left renal artery (AAST Grade V). Traumatic transection thought less likely given the absence of a large perivascular haematoma or contrast blush. No urinary contrast so a collecting system injury can’t be ruled out.
- Linear region of contrast in the posterior mid left kidney likely represents a small region of perfusion rather than a renal laceration with active bleeding given the absence of surrounding fluid or stranding.
- Left adrenal haematoma.
- Transection of the pancreatic body (AAST Grade III). High risk of pancreatic duct injury.
- Splenic laceration (AAST Grade I) and left lobe of liver laceration (AAST Grade I). No active contrast extravasation.
- Retroperitoneal haematoma tracking into the lienorenal and gastrosplenic ligaments.
- Small haemoperitoneum
- Tampon in situ