PMC3014821_01
CT scan of the abdomen in portal venous phase showing fluid around the liver (white arrow), difficult to appreciate any splenic change. Lacerated left kidney with perinephric haematoma (black arrow).
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fig1
The liver, spleen, pancreas, gall-bladder, and right kidney appeared normal; however, there was some image degradation artefact secondary to the arms being by the side of the abdomen (Figures 1(a) and 1(b)).
Followup CT scan of the abdomen in portal venous phase shows relative hypodensity of the spleen (white arrow), increase in intraperitoneal fluid, and unchanged appearance of  left kidney.
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fig2
There was decreased enhancement of the spleen, suggesting a splenic injury (Figures 2(a) and 2(b)).
Case I: Appeared intact on CT but avulsed and in 2 pieces at laparotomy.
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fig3
He underwent an emergency laparotomy, and the spleen was found to be completely avulsed and in two pieces (Figure 3).
PMC3014821_02
Contrast enhanced CT of the abdomen showing relative hypodensity of the spleen (white arrow), with extravasation of the contrast at the hilum suggestive of active bleeding (black arrow).
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fig4
There was active extravasation of contrast around the splenic hilum suggestive of ongoing active bleeding (Figures 4(a) and 4(b)).