CT - CT Angiography
Axial non-contrast
Axial C+ arterial phase
Axial C+ portal venous phase
Axial C+ delayed
The left psoas, iliacus, and quadratus lumborum muscles are markedly enlarged compared to the right, with adjacent fat streakiness.
Hyperdense foci are seen within these muscles in the arterial phase and increase in size in the portal venous and delayed phases, suggestive of active bleed.
The left external oblique, left internal oblique, and left tranversus abdominis muscles are also enlarged.
Haematoma extending from the level of renal arteries superiorly to the pelvic region inferiorly. Laterally, the haematoma extends to the left paracolic gutter, perirenal space, and also the pancreatic tail.
The left kidney is displaced anteriorly with perinephric streakiness, but it still demonstrates normal enhancement.
Ascites at the perihepatic region and right paracolic gutter.