Age: 20
Sex: Female
Indication: Trauma
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Case #44
Findings
- Chest
- Patchy groundglass opacities in the dependent aspects of both lower lobes, bilateral perihilar regions, and along the anterior aspect of the left upper lobe
- Secretions layering in the upper thoracic esophagus
- No pneumothorax
- Abdomen/Pelvis
- Shattered left kidney with devascularization of the upper pole and fragmentation of the lower pole
- Complex surrounding collection tracking into the left paracolic gutter
- No direct findings of urine extravasation on delayed phase images
- Small nonocclusive filling defect in the left renal vein
- Linear hypodensity in the posterior aspect of the left hepatic lobe measuring 1.5 cm with adjacent small volume hemorrhage
- Multiple small linear hypodensities in the spleen with the largest measuring 1.3 cm
- Rounded centrally hypodense structure in the endometrial cavity
- 2.7 cm right ovarian cyst
- Bladder is partially decompressed around a Foley catheter
- Accessory left hepatic artery from the left gastric artery
- MSK
- Acute left sacral fracture with involvement of the left S1 and S2 neural foramina and extension into the left sacroiliac joint
- Acute nondisplaced fracture of the anterior wall of the left acetabulum, left pubic root, and left inferior pubic ramus
- No diastasis of the pubic symphysis or sacroiliac joints
Diagnosis
- Renal laceration
- Hepatic laceration
- Splenic laceration
- Intrauterine pregnancy
Sample Report
Shattered left kidney with devascularization of the upper pole and fragmentation of the lower pole. Complex surrounding collection likely represents a combination of the hematoma and urine leak although a urine leak is not directly visualized on delayed phase images.
Nonocclusive thrombus in the left renal vein, possibly related to traumatic intimal injury.
Small left hepatic lobe and splenic lacerations (grade 2) without evidence of active hemorrhage.
Airspace opacities likely represent a combination of aspiration and contusion. No pneumothorax.
Lateral compression type left sacral and obturator ring fractures and nondisplaced fracture of the anterior wall of the left acetabulum.
Fluid-filled structure in the endometrial canal which may represent an early pregnancy. Recommend correlation with beta-hCG and pelvic ultrasound.
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