Presentation
Motorbike accident. Upper abdominal pain. FAST negative.
Patient Data
Fat stranding and small volume of blood within the left upper quadrant and left retroperitoneal space. A linear hypodensity is seen through the tail of the pancreas. Dense left adrenal nodule most likely represents a hematoma in this context. There is a small left perinephric hematoma.
- Blue arrow = linear hypodensity through edematous pancreatic tail reflecting a pancreatic laceration.
- Yellow arrow = left adrenal nodule, presumably a hematoma.
- Red arrow = peripancreatic fluid, fat stranding and hematoma.
Case Discussion
This pancreatic laceration was managed non-operatively, although the patient did go on to develop a pseudocyst.
Pancreatic lacerations can be difficult to identify but as in this case, there are a few subtle clues such as pancreatic edema, linear hypodensity, as well as surrounding fat stranding and fluid/hematoma.