Spontaneous rupture of hepatocellular carcinoma
Right sided abdominal pain.
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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.