School ager with abdominal pain after motor vehicle accident

CT of liver laceration and adrenal hemorrhage
AXR AP (above) obtained after an outside upper GI exam which demonstrated normal bowel rotation shows contrast filling multiple dilated loops of small bowel. Initial AP image from an enema (below left) shows a microcolon with contrast almost reaching the cecum. Later image from the enema (below right) shows reflux of contrast into dilated loops of distal ileum in the right lower quadrant.

The diagnosis was liver laceration with associated right adrenal hemorrhage.