LIVER LACERATION WITH ASSOCIATED INTRAPERITONEAL BLOOD

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The arrow points to a linear area of low attenuation within the posterior segment of the right lobe of the liver on this intravenously enhanced CT scan examination. There is also peri-portal tracking of blood. The arrow heads point to blood around the liver, as well as in the superior most aspect of the left paracolic gutter and should be considered suspicious for a hemo-peritoneum. The chest tube is along the subcutaneous tissues of the right lateral abdominal wall.

FLUID IN MORRISON'S POUCH

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On the intravenously enhanced CT scan examination there is fluid within Morrison's pouch; which lies between the liver and the right kidney. (Note asterisks). In trauma, this should be viewed suspicious for blood.

FLUID IN MORRISON'S POUCH

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Fluid is noted within Morrison's pouch as evidenced by low attenuation which interdigitates among the bowel loops. (Note asterisks.) This should be viewed as suspicious for blood in the setting of trauma. In rapid intraperitoneal hemorrhage, blood accumulates in the recto-vesicle pouch initially in a majority of cases. Hence, all abdominal CT examinations done for ruling out the possibility of trauma should always include the pelvis.

BILATERAL PNEUMOTHORACES

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The axial CT scan examination in the lower chest demonstrates the presence of air anteriorly within each hemithorax within the confines of the pleura (note arrow). Also note the bilateral lower lobe consolidation of lung, right being greater than left. There is a chest tube within the right hemithorax.

Whenever an abdominal CT examination is done, the lung bases are always included to exclude gross lung or mediastinal pathology.