Multiple areas of active bleeding from bowel and mesentery within the abdomen and pelvis. Further areas of active bleeding in the left iliacus muscle, paraspinal muscles and right posterior abdominal wall. Evidence of severe shock with slitlike IVC and poor hepatic, splenic and bowel wall enhancement.
Abdominal aortic injury with extraluminal contrast cuff and further areas of punctate and linear extraliminal contrast most likely representing pseudoaneurysms. Dissection of the left common iliac, coeliac axis and superior mesenteric arteries just beyond their origins.
Large volume of haemoperitoneum and intraperitoneal free gas. Right upper renal pole infarct. Extensive subcutaneous emphysema. Retroperitoneal gas and spinal epidural is also present.
L3/4 intervertebral disc space and facet joint widening, highly suspicious for unstable discoligamentous injury. Minor left iliac wing fracture. Spinal epidural and intrathecal active bleeding at the level of T12/L1.