What injuries are present?
Left upper pole renal laceration. Possible splenic flexure injury. Possible spinal epidural haematoma.
The metallic projectile traversed through the left upper quadrant lacerated the upper pole of the left kidney.
Numerous locules of the free gas within the peritoneal cavity as well as retroperitoneally and behind the left diaphragmatic crus.
The projectile has eventually stopped adjacent to the left pedicle of L1, just above the intervertebral foramen, with a small psoas haematoma.
There are small locules of gas within the spinal canal, with an impression for increased segmental density anterior to the cord/dura. This can be due to beam hardening artefact and radicular vessels or intraspinal venous plexus; however, possible small epidural collection can not be definitely excluded and correlation with the neurological findings may be of help.
There is a small left paracolic and LUQ intraperitoneal fluid which may be urine; however, proximal descending colon is asymmetrically thickened and given the course of the projectile, there is a strong suspicion for injury.
Solid abdominal viscera are otherwise unremarkable. No lymphadenopathy.
Uncomplicated diverticular disease with a loop of the sigmoid colon contained within the left direct inguinal hernia.
Mildly displaced right L1 and L2 transverse process fractures.