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Age: 22

Sex: Male

Indication: Trauma (motor vehicle accident)

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Case #5


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 contrast density in the perinephric hematoma which become larger on delayed phase images
    • Filling defects within opacified upper and interpolar left renal calyces
    • Small linear hypodensities in the inferior tip of the spleen
    • Retroperitoneal hemorrhage surrounds the pancreas without discrete pancreatic laceration
    • 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

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Images

Red arrows: urine leak from the left renal collecting system confirmed on subsequent CT urogram.



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