Spontaneous rupture of hepatocellular carcinoma

Presentation

Right sided abdominal pain.

Patient Data

Age: 60 years
Gender: Male

Mildly enlarged liver with irregular outline, deepened fissures and prominent caudate lobe. An exophytic focal lesion measuring about 10 x 10 cm noted in segment VII and showing early arterial enhancement and delayed washout with localized perilesional and perihepatic mild collection producing a typical sentinel clot sign ( US guided aspiration revealed bloody collection) denoting its rupture. No extra or intrahepatic biliary channel dilatation.

Moderate free ascites.

Case Discussion

Liver cirrhosis complicated with right hepatic lobe ruptured hepatocellular carcinoma.

"Sentinel clot sign" is a very important CT sign pointing to the site of bleeding with the surrounding blood being fluid density in appearance.

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