EURORAD ESR

Case 14064

A case of acute abdomen caused by ruptured bifocal HCC

Author(s)
Eleonora Tricarico1, Francesco Tricarico2, Domenica Tritto3, Bianca Pascazio4, Enrico Restini4, Carlo Florio 3

(1) C. B. H. Mater Dei, Dpt of Radiology, Bari, Italy; Email:eleonoratric@gmail.com
(2) P.O. San Paolo, Dpt of Radiology, Bari, Italy.
(3) C. B. H. Mater Dei, Dpt of Radiology, Bari, Italy
(4) C. B. H. Mater Dei, Dpt of Surgery, Bari, Italy
 
Patient
female, 85 year(s)
 
 
  • Figure 1
    CT unenhanced axial image

    CT images performed before injection of contrast medium reveals free peritoneal fluid with higher attenuation in the right subhepatic space (arrow)

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;
     
     
  • Figure 2
    CT enhanced axial images
     

    CT image performed after injection of contrast medium reveals an heterogeneous capsulated hepatic nodule in III segment, showing intralesional active extravasation of contrast medium (arrow).

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;

    CT image performed after injection of contrast medium reveals another protrusive capsulated hepatic nodule in VI segment, presenting peripheral hypodense area (arrow), suggesting the point of rupture through the liver...

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;

    CT image performed after injection of contrast medium reveals active intraperitoneal bleeding (arrow) in subhepatic space.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;
     
     
  • Figure 3
    CT enhanced coronal and sagittal images
     

    CT image performed after injection of contrast medium reveals two protrusive capsulated liver nodules of III and VI liver segments, with active intraperitoneal bleeding (arrow) below the nodule of VI segment.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;

    CT image performed after injection of contrast medium reveals a protrusive capsulated hepatic nodule of VI segment, presenting peripheral hypodense area (arrow), suggesting the point of rupture through the liver capsule.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;

    CT sagittal image performed after injection of contrast medium reveals hepatic nodule in VI segment, presenting peripheral hypodense area (green arrow) and adjacent active intraperitoneal bleeding (yellow arrow).

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;

    CT sagittal image performed after injection of contrast medium reveals hepatic nodule in VI segment, presenting peripheral hypodense area and adjacent active intraperitoneal bleeding.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;
     
     
  • Figure 4
    Surgical exploration
     

    Surgical exploration revealed two protrusive nodules of III and VI liver segments.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Surgery; Special Focus: Neoplasia;

    Surgical exploration revealed the ruptured and bleeding nodule of VI segment.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Surgery; Special Focus: Neoplasia;
     
     
CT images performed before injection of contrast medium reveals free peritoneal fluid with higher attenuation in the right subhepatic space (arrow)
 
CT image performed after injection of contrast medium reveals an heterogeneous capsulated hepatic nodule in III segment, showing intralesional active extravasation of contrast medium (arrow).
 
CT image performed after injection of contrast medium reveals another protrusive capsulated hepatic nodule in VI segment, presenting peripheral hypodense area (arrow), suggesting the point of rupture through the liver capsule.
 
CT image performed after injection of contrast medium reveals active intraperitoneal bleeding (arrow) in subhepatic space.
 
CT image performed after injection of contrast medium reveals two protrusive capsulated liver nodules of III and VI liver segments, with active intraperitoneal bleeding (arrow) below the nodule of VI segment.
 
CT image performed after injection of contrast medium reveals a protrusive capsulated hepatic nodule of VI segment, presenting peripheral hypodense area (arrow), suggesting the point of rupture through the liver capsule.
 
CT sagittal image performed after injection of contrast medium reveals hepatic nodule in VI segment, presenting peripheral hypodense area (green arrow) and adjacent active intraperitoneal bleeding (yellow arrow).
 
CT sagittal image performed after injection of contrast medium reveals hepatic nodule in VI segment, presenting peripheral hypodense area and adjacent active intraperitoneal bleeding.
 
Surgical exploration revealed two protrusive nodules of III and VI liver segments.
 
Surgical exploration revealed the ruptured and bleeding nodule of VI segment.
 
 
 
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