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C-2461 - Pictorial review: Spontaneous liver haemorrhage - from diagnosis to intervention and follow up

I. Caglič, E. Godfrey, S. Upponi, S. Whitley, D. J. Lomas; Cambridge/UK Type: Educational Exhibit
Area of Interests: Vascular, Liver, Abdomen
Imaging Techniques: CT, CT-Angiography, MR
Procedures: Embolisation, Diagnostic procedure
Special Focus: Hemorrhage
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Learning objectives: 1. To describe the different causes of spontaneous liver haemorrhage.   2. To descibe an appropriate imaging protocol and technique for reporting in order to: - detect haemorrhage and to identify active bleeding; - determine the cause and to suggest further management. [...]

Background: Spontaneous liver haemorrhage is a rare but serious entity.   Clinical signs are relatively non-specific as patients usually present with severe abdominal pain often accompanied with abdominal distension and hematocrit reduction.   The most common cause is a rupture of an underly[...]

Findings and procedure details: IMAGING PROTOCOL Multidetector Computed Tomography (MDCT) with triple phase is considered best practice for the diagnosis of spontaneous liver bleeding. Each of the three phases has a specific role:   1. PRECONTRAST SCAN: Detects haemoperitoneum and sentinel clot sign.   a) HAEMOPER[...]

Conclusion: Spontaneous liver haemorrhage typically presents acutely and requires a prompt triple phase CT examination to enable a diagnosis and facilitate appropriate clinical management. An understanding of the appearance and evolution of haemorrhage along with a knowledge of the potential underlying lesions [...]

Personal information: Iztok Caglic, Clinical Fellow in Radiology Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge/UK Email: iztok.caglic@addenbrookes.nhs.uk, iztokcaglic@gmail.com

References: 1. S. Srinivasa, W.G. Lee, A. Aldameh, J.B. Koea, Spontaneous hepatic haemorrhage: A review of pathogenesis, aetiology and treatment, Hpb. 17 (2015) 872–880. doi:10.1111/hpb.12474. 2. N. Battula, D. Tsapralis, A. Takhar, C. Coldham, D. Mayer, J. Isaac, P. Muiesan, R.P. Sutcliffe, R. Marudanay[...]

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