Presentation
Pedestrian versus motorcycle. Severe pain on the patient’s right side.
Patient Data
Multiple deep linear branching hypodensities involving all four right liver segments extending to the capsular surface and right hepatic vein in keeping with liver lacerations. Associated large non-enhancing region in segment VII/VIII parenchymal hematoma. This region is in continuity with a hypodense subcapsular collection. There is no evidence of contrast blush to suggest active bleeding. The vascular pedicle is intact.
Minimal fluid in the hepatorenal pouch.
No intrahepatic biliary duct dilatation. Normal contrast enhancement of the main portal vein and its branches.
Case Discussion
The patient underwent two ultrasound examinations—one was normal, and the other showed a hematoma, but its exact location could not be determined. This led to a CT scan of the abdomen and pelvis for further evaluation, with CT findings of a liver laceration with juxtavascular extennsion and subcapsular hematoma (AAST grade V injury).
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