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Case of the Month

June 2015

Patient Data: 20 year old male patient

Clinical Info: Has had an elbow between the ribs during a sporting activity


56274-Afbeelding1.jpg
Liver abnormality


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Another image of the lesion


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The lesion is not vascularized


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There is no blood in the abdominal cavity


56284-Mijn_Film_2.swf CT


56285-Mijn_Film_3.swf CT


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The same liver two days later


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Again the lesion is not vascularized


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And there is no blood in the peritoneal cavity


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The same liver a few weeks later. The lesion is now completely liquefied.


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The lesion proved to be a posttraumatic intraparenchymal liver hematoma without free peritoneal blood


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This is the longitudinal image of the lower abdomen of a 16 year old girl that also had a blunt abdominal trauma


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This is the transverse image of the lower abdomen of the same patient


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The liver is very inhomogeneous


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Again the liver shows an extensive inhomogeneous area and there is an abnormality between the right diaphragm and liver


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Another image of the abnormality between liver and diaphragm


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Another image of the abnormal liver and abnormality between liver and diaphragm


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Last image of the inhomogeneous liver and lesion between liver and diaphragm


61108-Mijn_Film_3.swf The CT scan shows a large liver rupture and subcapsular hematoma, but no free peritoneal blood

Both patients had posttraumatic liver abnormaities. But in both cases there was no blood in the peritoneal cavity. Absence of peritoneal blood does not always exclude a liver rupture. In case of a blunt abdominal trauma beware of parenchymal injuries without free peritoneal blood

For other cases of traumatic liver abnormalities see

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