SPLENIC LACERATION WITH HEMOPERITONEUM
The use of intravenous contrast unless absolutely contraindicated is essential to rule out visceral laceration as well as to determine the perfusion of the abdominal viscera. The use of oral contrast is imperative to differentiate between unopacified bowel and free intraperitoneal fluid.
This case demonstrates (arrow) the presence of a linear area of low attenuation within the splenic parenchyma compatible with a splenic laceration. Free intraperitoneal fluid is noted around the spleen, as well as around the liver which should be considered blood until proven otherwise.
ACTIVE BLEEDING INTO SUBCAPSULAR SPLENIC HEMATOMA WITH HEMOPERITONEUM.
The single arrow points to the subcapsular fluid collection around the spleen. The areas of high attenuation adjacent to the arrow demonstrate the rare demonstration of extravasated intravenously administrative contrast material, and represents the radiologic equivalent of active bleeding.
Fluid within the right paracolic gutter is compatible with hemoperitoneum.
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