[Unsuspected hepatic rupture with peritoneal extravasation of contrast media revealed by computed tomography]

Computed tomography (CT) plays a major role as the initial diagnostic tool in adult blunt abdominal trauma. Indications of CT are hemodynamical instability, abdominal defense and high-speed deceleration. We present the case of a 22 year-old man involved in a motor-vehicle accident admitted in our emergency department with headache but without clinical signs of intraabdominal trauma. The abdominal CT was asked because of the high-speed deceleration and because the patient had to come to the CT room for a head CT. The abdominal multislice helical CT performed with contrast bolus injection showed a massive intraperitoneal extravasation from a hepatic laceration and avulsion. The patient died during operation despite immediate management of the abdominal traumatic lesions detected by CT.