PMC9529660_01
Enlarged spleen with active hematoma and extravasation visible as indicated by the darker areas within the spleen (red arrow). The extravasated blood can also be appreciated around the liver, seen as the dark crescent shape on the lateral border of the liver (yellow arrow).
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CT of the abdomen and pelvis with contrast demonstrated splenomegaly, active extravasation into the anterior superior capsule with a large sub-capsular and perisplenic hematoma, and a large hemoperitoneum, consistent with grade IV splenic rupture (Fig. 1).
Splenic artery angiography. (A) demonstrates active extravasation as seen by the subtly darker areas indicating contrast outside the blood vessels (red arrows), suggestive of ongoing hemorrhage. (B) demonstrates post-embolization sequences where these darker patches are no longer visible.
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Interventional radiology (IR) was consulted and performed a superior pole splenic artery embolization (Fig. 2).