Demographics:
22 years old, Male
Indication:
Trauma (motor vehicle accident)
Findings
Chest
- Trace left hemopneumothorax
Abdomen/Pelvis
- Large left renal laceration with absent enhancement of the lower half of the left kidney and large perinephric hematoma. Areas of hyperattenuation in the perinephric hematoma which enlarge on delayed phase images
- Filling defects within opacified upper and interpolar left renal calyces
- Small linear areas of hypoattenuation in the inferior tip of the spleen
- Retroperitoneal hemorrhage surrounds the pancreas without discrete pancreatic laceration
- Retroperitoneal hemorrhage tracks inferiorly into the presacral space
- High attenuation material layering in the gallbladder
MSK
- No acute fracture
Diagnosis
Renal laceration
Sample Report
High-grade left renal laceration with devascularization of the inferior half of the kidney and large perinephric hematoma with areas of active extravasation.
Filling defects in the left renal collecting system could represent debris or blood clot. Given hilar involvement, a CT urogram should be considered to assess for urine leak.
Grade I laceration along the inferior margin of the spleen.
Retroperitoneal hemorrhage surrounds the pancreas. Although no discrete pancreatic laceration is seen, an occult injury is not excluded.
Trace left hemopneumothorax.
Discussion