Scout image shows paperclip in right posterior hip and left thigh, indicating entry and exit wounds. Old bullet fragments project over the right lower chest.
Bullet trajectory: right posterior hip through iliac bone, right iliacus with small foci of active extravasation, mesentery with active extravasation, left thigh.
Follow the SMA - it loses flow at the level of the upper iliac bones due to injury. There is flow in the ileocolic branches, and therefore enhancement in the TI and cecum. However, the distal ileal branches are completely out. Following the TI retrograde, you will end up in indistinct, hypoenhancing small bowel in the right lower quadrant.
Hypoenhancement of several segments of ileum in the right lower quadrant, which are difficult to distinguish from the hemoperitoneum.
Probable contusion along the bladder dome.
Large amount of hemoperitoneum.
Cleft in liver and spleen.
Delayed images: accumulation of extravasated contrast in the mesentery.