PMC3299142_01
Axial unenhanced (a) and contrast-enhanced (b) images of the upper abdomen reveal splenomegaly with stratified subcapsular and perisplenic hyperdensity consistent with ruptured splenomegaly and clotted hemorrhage. Axial unenhanced image of the pelvis (c) and post-contrast panoramic coronal-reformatted image (d) show moderately hyperdense (30-40 HU) effusion (asterisks) occupying the Douglas pouch as well as other peritoneal compartments
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F1
Prompt investigation with multi-detector CT [Figure 1] allowed confident diagnosis of diffuse, moderately hyperdense peritoneal effusion consistent with hemoperitoneum and splenomegaly with hyperdense, stratified subcapsular and perisplenic clotted hematoma.