Russo Gaetano Maria, Zoi Evangelia, D'Iglio Imma, Mangoni di Santo Stefano Maria Luisa
Ospedali Riuniti Area Nolana, 80035 Napoli, Italy.
Diagnostics (Basel). 2024 Sep 21;14(18):2088. doi: 10.3390/diagnostics14182088.
A rare case of atraumatic liver laceration associated with hemoperitoneum is presented in a patient with amyloidosis who came to the hospital for abdominal pain. The imaging findings reveal significant hepatomegaly with finely heterogeneous hepatic density and subcapsular hypo-dense streaks in segments VI and VII, likely representing lesions. Post-contrast enhancement shows a punctiform contrast medium extravasation within the subhepatic fluid collection, visible from the arterial phase and intensifying in subsequent study phases. These imaging findings suggest an atraumatic hepatic laceration, a diagnosis confirmed by the presence of hemoperitoneum distributed bilaterally under the diaphragm, in the paracolic gutters, along the mesentery root, and predominantly in the peri-hepatic region. The detailed imaging analysis provided critical insights into the diagnosis and management of this rare clinical presentation.
本文报告了一例罕见的非创伤性肝撕裂伤合并腹腔积血病例,患者为一名淀粉样变性患者,因腹痛入院。影像学检查结果显示肝脏明显肿大,肝密度细微不均,VI段和VII段有包膜下低密度条纹,可能为病变。增强扫描显示肝下液性积聚内有斑点状造影剂外渗,动脉期可见,在后续检查阶段强化。这些影像学表现提示为非创伤性肝撕裂伤,双侧膈下、结肠旁沟、肠系膜根部及主要在肝周区域存在腹腔积血证实了这一诊断。详细的影像学分析为这一罕见临床表现的诊断和治疗提供了关键见解。