Blunt abdominal trauma with broad ligament injury

Case contribution: Dr Radhiana Hassan


  • A 14 years old girl
  • Involved in MVA, back passenger in a car.
  • Assessment showed a closed fracture of distal end right fibula
  • POP applied and patient was discharged home.
  • Presented 2 days later with severe abdominal pain and vomiting.
  • Noted to be dehydrated from the vomitting.
  • Also noted drop in Hb from 11 gm/dL to 10 gm/dL
Contrast-enhanced CT scan of abdomen and pelvis in axial plane soft tissue window

CT scan findings:

  • A laceration is seen at lower pole of left spleen (red arrows)
  • Less than 3 cm and no active bleed is seen
  • No blood collection surrounding the spleen
  • Minimal fat streakiness at posterior perisplenic area
  • Minimal free fluid at pelvic region
  • The left broad ligament is thickened (yellow arrow)
  • The uterus also shows heterogenous enhancement with fat streakiness at left lateral wall

Intra-operative findings:

  • No capsular laceration seen.
  • No perisplenic blood pooling.
  • Lacerated left broad ligament and bleeding from branch of left ovarian artery.
  • Uterus is normal

Diagnosis: Grade II spleen injury and broad ligament injury from blunt abdominal trauma


  • Broad ligament injury is rarely reported as a result of blunt abdominal trauma
  • It can be dangerous as they may be silent and not cause obvious vaginal bleeding
  • Bilateral broad ligament hematomas in the absence of any injury to the uterus has been reported following pelvic fractures sustained in a pregnant woman during a motor vehicle accident.
  • Broad ligament hinjury may be treated either conservatively with blood transfusion, fluid resuscitation, and observation or with surgical exploration and evacuation.
Author: radhianahassan