Major CT imaging features of hollow organ traumatic injury
With hollow organ injury, CT may show contusion; ischemia or infarction; hemorrhage, sometimes with active bleeding; and perforation. Contusion of a hollow organ generally appears as wall thickening with patchy enhancement, sometimes with increased attenuation because of intramural hemorrhage. Adjacent mesenteric or retroperitoneal stranding, fluid, or hemorrhage may be visualized.
With bowel injury, associated imaging features of bowel perforation, as previously described, may also be present.
With bladder rupture, fluid attenuation urine may be seen in the extraperitoneal space (with extraperitoneal bladder rupture) or less commonly in the peritoneal space (with intraperitoneal bladder rupture) that opacifies with renally excreted intravenous contrast material during the excretory phase of enhancement. With rupture of the collecting system or ureter, similar findings of extraluminal fluid attenuation urine with contrast opacification during the excretory phase of enhancement may be seen in the retroperitoneum.