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RADIOLOGY: ABDOMEN: Case# 33722: MULTIPLE RIGHT-SIDED RIB FRACTURES, HEPATIC LACERATION, FOCAL SPLENIC INJURY. The patient is a 37 year old male who was intoxicated and caught underneath a tractor. 1. Multiple right-sided rib fractures with segment of flail chest. Moderately large right hydropneumothorax with pneumomediastinum. Suboptimal chest tube placements as described above. The posterior/inferior chest tube passes through the peritoneal cavity through the parenchyma of the liver, through the diaphragm and into the right pleural space to abut the right atrium. 2. Hepatic laceration and large area of liver infarction involving the entire posterior segment of the right lobe. Laceration extends close to the level of the IVC. Probable active extravasation into the hepatic laceration. 3. Small amount of free fluid around the spleen with irregularity of the anterior tip of the spleen which may represent focal splenic injury. 4. Massive pneumoperitoneum may be the result of chest tube crossing the peritoneal space, but a bowel injury cannot be excluded.
- Author
- Peter Anderson
- Posted on
- Thursday 1 August 2013
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