Is there an intraperitoneal injury?
Findings are highly suggestive of bowel injury: free gas; free fluid and bowel wall thickening.
Multiple locules of free gas. Low-density (10 HU) free fluid within the pelvis and both paracolic gutters. Fat stranding surrounds colon at the junction of descending/sigmoid in the left lower quadrant. Ileal loops in the right lower quadrant have hyperenhancing walls. Extensive subcutaneous fat stranding/haematoma of the anterior lateral pelvis and right flank.
Comminuted and displaced fracture of the left ilium, with a fracture line extending to the left sacro-iliac joint. Associated gluteal and iliac muscle haematoma. Small bone fragment anterior to the left sacro-iliac joint is equivocal for fracture (differential is degenerative change).