Hepatic congestion

Case contributed by Paul Simkin
Diagnosis almost certain

Presentation

Trauma.

Patient Data

Age: 80 years
Gender: Male
ct

Bilateral pleural effusions, larger on the right, are associated with basal atelectasis: these findings are most likely due to pulmonary edema. Cardiac enlargement and previous sternotomy indicate underlying cardiac disease.

Fluid within the abdomen and pelvis is low density, keeping with ascites rather than hemoperitoneum. Heterogeneous enhancement of the liver, which appears enlarged, represents congestive hepatopathy.

No evidence of traumatic injury to the liver, spleen, pancreas, or kidneys. Calcification in the pancreatic head may be due to previous pancreatitis. The adrenals, gallbladder and bladder are unremarkable. Uncomplicated sigmoid diverticulosis, otherwise the bowel has a normal appearance.

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