Penetrating liver laceration grade III by gunshot injury. Contrast-enhanced CT (a, b) axial and (c) coronal reformatted images show linear low-density laceration of the liver (thin black arrow) with high-density contrast mixed with active hemorrhage (thin white arrow) within it which is also extending into the subphrenic space (thick white arrow), a bullet adjacent to the rib (thick black arrow) and with small focus of gas (arrowhead). (d, e) Axial and coronal reformatted CTs 1 week later show high-density hematoma in the laceration (black arrow) and perihepatic space (white arrow) but no active hemorrhage

Liver laceration, lung contusion, and tear of the diaphragm from penetrating trauma. (a) Axial CT and (b) coronal and (c) sagittal reformatted images show low-density laceration of the dome of the right lobe of the liver continuous with the adjacent pulmonary contusion. The diaphragm is discontinuous posteriorly (arrow)

Subcapsular hemorrhage from PTC drain placement. History of laparoscopic cholecystectomy and impacted stone in CBD followed by PTC drain placement. (a, b) Axial CT and coronal reformatted images show a thin linear capsule (black arrows) surrounding the hemorrhagic fluid (ellipse also in d) that is compressing and deforming the liver surface (white arrows) and is extending from the liver parenchyma (arrowhead). (c, d) Coronal and sagittal reformatted images show hemorrhage tract (white arrow) extending from near the biliary drain (black arrow). (e) T-tube cholangiogram shows multiple stones in the common bile duct as filling defects (black arrows) with contrast flowing into the duodenum (white arrow)

Liver laceration grade IV with high-density hematoma from blunt trauma and well-marginated biloma replacing the hematoma a month later, which was drained. Axial CT and coronal and sagittal reformatted images (a– c) show laceration with hematoma (black arrow) involving porta hepatis and causing mass effect on the IVC (white arrow in c). (d, e) Axial and sagittal reformatted images 1 month later show two loculated low-density fluid collections continuous with the biliary duct (white arrow) which were drained

Laceration of the liver and injury to the biliary ducts. Axial CT (a) shows laceration of the right lobe of the liver (black arrow) by a bullet (white arrow). (b) At a higher level than (a), gas is seen in the biliary tree (black arrow), and large biloma is seen with layered gas (white arrow) distending the liver capsule and outside the liver parenchyma (arrowhead). (c) ERCP examination shows leakage of contrast (black arrow) with drainage catheter (white arrow)

Hematoma involving the liver parenchyma and subcapsular region with active bleeding by angiogram, with history of blunt trauma. Axial CT (a) precontrast shows high-density hematoma involving segment VI and protruding inferiorly with subcapsular extension. (b) Postcontrast study does not show active hemorrhage within the hematoma. (c) Angiogram of the hepatic artery shows faint blush of extravasation in the early part of the study. (d) Delayed phase of the study shows increased extravasation of contrast

Splenic laceration in different patients. Patient 1: (a) axial contrast-enhanced CT following blunt trauma shows grade III laceration with injury to the trabecular vessels and intraparenchymal pooling of contrast (black arrows). Cortical tear is also seen with active bleeding into the peritoneal cavity (white arrow). Patient 2: (b, c) axial and (d) coronal reformatted CTs following penetrating wound show active bleeding from the spleen into the peritoneal cavity (arrows). Patient 3: (e) axial noncontrast image shows linear high-density hematoma within laceration (arrow). (f, g) CECT shows linear tear of the spleen (arrow) and large subcapsular hemorrhage (ellipse)

Tear and laceration of the pancreas in three patients with trauma. Patient 1: (a) axial CT shows complete tear of the neck (white arrow) and at the tail (black arrow). The surrounding low-density fluid is leaking pancreatic fluid from the tear of the pancreatic duct. Patient 2: (b) axial CT following a stab wound shows incomplete tear at the tail of the pancreas (black arrow) with surrounding small high-density hematoma (white arrow). Patient 3: (c, d) axial CT shows multiple incomplete tears of the tail of the pancreas (black arrows) with surrounding high-density hematoma (white arrow)