The laceration extends to the region of the portal veins and portal vein confluence. There is evidence of subcapsular hematoma as well as free blood around the liver. There are multiple linear areas of low attenuation in the spleen consistent with splenic laceration and contusion. There is free fluid around the spleen as well. There is an area of low attenuation between the body and head of the pancreas just anterior to the superior mesenteric vein which raises the concern of pancreatic transection.
Pancreatic trauma is uncommon and associated with a high mortality since it is often occult.
It is usually the result of blunt trauma, particularly child abuse. Trauma to the pancreas may cause pancreatitis, lacerations, and transections. Pancreatic enlargement may also be evident. A feature common to most hepatic injury is intrahepatic hemorrhage. Hemorrhage often has a layered appearance caused by successive bleeding and clotting.