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Figure 17b.   Shattered kidney (category III) in a 28-year-old man who had sustained blunt abdominal trauma. (a) Contrast-enhanced helical CT scan demonstrates a devitalized upper pole of the right kidney due to segmental infarction (R). Note the perinephric hyperattenuating blood clot (arrow). Note also the flattened inferior vena cava (V), a finding that indicates hypovolemic shock. (b) CT scan obtained caudad to a demonstrates a large parenchymal laceration extending horizontally across the middle to lower pole of the right kidney (R), which is displaced anteriorly by a large, perinephric hematoma (H).