99mTc-sulfur colloid scans for acute abdominal trauma have an approximate clinical accuracy of 80-85percnt; in the diagnosis of hepatosplenic laceration or hematoma. Various details of liver-spleen injury in the acutely traumatized patient are discussed with a previously unassociated subtle scan finding, which may increase the diagnostic accuracy of this radioisotope procedure to over 90percnt;. This subtle scan finding in the trauma patient consists of a significant uptake of sulfur colloid by the reticuloendothelial system in the spine, a finding heretofore associated with such processes as hepatocellular disease and anemia. This spine ldquo;shine through,rdquo; in our experience, can be asociated with significant abdominal or thoraco-abdominal trauma with hemorrhage. The pathogenesis is most likely related to splanchnic vessel vasospasm with shunting of blood and radiocolloid from the visceral pool. This additional information has served to significantly increase the positive yield in trauma cases where hepatosplenic trauma with hemorrhage has been suspect.
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