PMC10318262_01
Computed tomography (CT) of the head. Head CT showing (A) no intracranial hematoma on arrival, although a temporal bone fracture is observed on the right side (arrowheads) (A, B). (C) Ten hours after admission, an epidural hematoma is observed under the fracture, and the midline is slightly shifted to the left.
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Head CT revealed right temporal and occipital bone fractures, pneumocephalus, and acute epidural hematoma (Figure 1A,B); the latter did not show any space-occupying effects. Anisocoria recurred on the night of admission and a CT revealed an increase in the acute epidural hematoma, which caused a midline shift (Figure 1C).
Computed tomography (CT) of the abdomen on arrival and surgical wound on the trunk. Abdominal CT on arrival shows (A) abdominal wall penetration into the peritoneal cavity (yellow arrowheads) and (B) fluid collection (red arrowheads) around the liver. (C) The inferior mesenteric vein is lacerated and was subsequently repaired by suturing with 5-0 proline (white arrowheads). (D) After hemostasis, the surgical site in the left thorax is closed with chest tube insertion (black arrowheads) and the abdomen is temporally closed with an ABTHERA system.
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Abdominal CT revealed extensive fluid retention in the abdominal cavity (Figure 2A,B), indicating the cause of the hemorrhagic shock. The inferior mesenteric vein was lacerated, although no other intra-abdominal organ injuries were observed; the vein was sutured (Figure 2C) and open abdomen management was performed using ABTHERA (Figure 2D).