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Abdomen » Hepatobiliary
Intra and extrahepatic hematomas
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Author(s) :
Chaitali Shah, FRCR
 
Presentation A 52-year-old woman with a history of acute myeloid leukemia and low platelet count presents with abdominal pain. An ultrasound of the abdomen was performed.
 
 
 
Caption: Transverse scan of the RUQ
Description: A large extra-hepatic fluid collection which is almost isoechoic to the liver parenchyma is seen anterior and lateral to the liver. The slightly more echogenic liver capsule is seen separating the extrahepatic fluid collection from the liver.
 
 
 
Caption: Sagittal image of RUQ
Description: A complex, predominantly cystic, intrahepatic fluid collection is seen in this image.
 
 
 
Caption: Sagittal color Doppler image of RUQ
Description: The intrahepatic complex fluid collection demonstrates no internal flow.
 
 
 
Caption: Color Doppler image of the RUQ
Description: Neither the intrahepatic nor the extrahepatic fluid collections show presence of vascularity. The ultrasound characteristics of both the fluid collections are consistent with the diagnosis of hematomas. One of the hepatic veins is seen coursing around the intrahepatic hematoma. Note the more echogenic liver capsule separating the liver from the extrahepatic hematoma.
 
Differential Diagnosis  Intra and extrahepatic hematomas
 
Final Diagnosis Intra and extrahepatic hematomas
 
Follow Up

A CT scan was performed which confirmed the ultrasound findings. 

 
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