EURORAD ESR

Case 13780

Intrathoracic viscera herniation and other thoracoabdominal injuries in a young female multitrauma patient: Computed Tomography evaluation

Author(s)
M. Smarda, N. Ifantis

General Hospital of Nikaia - Pireus,
Radiology Department;
3, Mantouvalou Str.,
Nikaia - Pireus,
18454 Greece;
Email:magda.3110@hotmail.com
 
Patient
female, 28 year(s)
 
 
  • Figure 1
    Same axial CT slices with lung and mediastinal windows respectively

    Bilateral pulmonary contusions (lung window) and intrathoracic gastric and hepatic herniation (both lung and mediastinal window). The 'dependent viscera sign' is present.

     
    Area of Interest: Emergency; Thorax; Trauma; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Hernia; Trauma;
     
     
  • Figure 2
    Coronal reformatted CT image (portal venous phase)

    Splenic laceration of the upper pole, haemoperitoneum and intrathoracic herniation of the stomach.

     
    Area of Interest: Abdomen; Spleen; Trauma; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Trauma;
     
     
  • Figure 3
    Axial CT image (bone window)

    Pelvic fractures are often encountered in patients with post-traumatic diaphragmatic tear, as in this particular case.

     
    Area of Interest: Bones; Trauma; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Trauma;
     
     
  • Figure 4
    Axial CT image (arterial phase)

    Active bleeding from mesenteric vessels.

     
    Area of Interest: Emergency; Pelvis; Trauma; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Haemorrhage; Trauma;
     
     
  • Figure 5
    Axial CT image (portal venous phase)

    Intraperitoneal free fluid, thickened small bowel loops (on the left) and collapsed I.V.C. (shock bowel findings).

     
    Area of Interest: Abdomen; Emergency; Small bowel; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Haemodynamics / Flow dynamics; Trauma;
     
     
  • Figure 6
    Coronal reformatted CT image

    Discontinuity and thickening of the left hemidiaphragm at the site of the rupture, as well as a waist-like constriction of the herniated organs (‘the collar sign’).

     
    Area of Interest: Abdomen; Thorax; Trauma; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Hernia; Trauma;
     
     
Bilateral pulmonary contusions (lung window) and intrathoracic gastric and hepatic herniation (both lung and mediastinal window). The 'dependent viscera sign' is present.
 
Splenic laceration of the upper pole, haemoperitoneum and intrathoracic herniation of the stomach.
 
Pelvic fractures are often encountered in patients with post-traumatic diaphragmatic tear, as in this particular case.
 
Active bleeding from mesenteric vessels.
 
Intraperitoneal free fluid, thickened small bowel loops (on the left) and collapsed I.V.C. (shock bowel findings).
 
Discontinuity and thickening of the left hemidiaphragm at the site of the rupture, as well as a waist-like constriction of the herniated organs (‘the collar sign’).
 
 
 
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