CT
Axial C+ portal venous phase
Coronal C+ portal venous phase
Sagittal C+ portal venous phase
- there are multiple lacerations/fractures involving the porta hepatis as well as segment 1,4, 5 & 8, most of the them extending through the whole width of the affected area and reach the peripheral hepatic margins. Active contrast extravasation noted centrally adjacent to the porta hepatis, indicating an active bleeding. Small amount of branching gas attenuation seen within segment 8. Diffuse hypo-enhancement of the liver parenchyma is also present.
- massive amount of free fluid within the abdomen and pelvis (hemoperitoneum).
- mild thickening with prominent enhancement of the wall of small bowel loops in the center of the abdomen (shock bowel).
- collapsed inferior cava along its course.
- small caliber of the abdominal aorta.
- hyper-enhancing pancreas with extensive retroperitoneal edema/fluid.
- hyper-enhancing adrenal glands.
- hypo-enhancing spleen and kidneys, with visible enhancement of the arcuate arteries and main renal arteries.