Hepatic laceration and contusion

Case contributed by Bruno Di Muzio
Diagnosis almost certain


Pedestrian vs. car trauma.

Patient Data

Age: 25 years
Gender: Female

CT Abdomen and pelvis


Irregular hypoattenuation with subcapsular clefts involving predominantly segments III, IVB, and V is compatible with hepatic laceration and contusion. Associated hemoperitoneum in hepatorenal recess, along with the right paracolic gutter and in the pelvis.

The gallbladder spleen, pancreas, kidneys and adrenal glands are unremarkable.

No abnormality of the bowel is identified.

There is no free gas in the abdomen. No lymph node enlargement. No pelvic fractures.

Case Discussion

Right upper quadrant injury with liver laceration/contusion and hemoperitoneum. This was considered a borderline grade III/IV according to the AAST

The patient also had non-displaced right 6th/7th rib fractures and mild pulmonary contusion lateral segment right middle lobe, not illustrated in this case. 

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