Presentation
Post PCI for LAD.
Patient Data
There are a number of distended loops of small bowel present, in addition to displacement from a soft tissue mass in the pelvis. No definite evidence of free gas or obstruction.
Right pelvic side wall hematoma, which displaces the bladder to the left.
This is an extraperitoneal bleed, associated with tracking of blood in the anterior paravesical space and a small amount of stranding in the lateral posterior pararenal space.
Two regions demonstrate minor arterial bleeding, in the anterosuperior and posterolateral parts, almost certainly arising from branches of the right internal iliac artery. This artery is patent proximally.
Case Discussion
Assessment of any bowel gas displacement, as well as pattern, is important on plain films. Bowel gas can be displaced for a number of reasons including hematoma, infection and malignancy.
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