Subcapsular liver hematoma with embolization

Case contributed by RMH Core Conditions


Football injury. RUQ pain.

Patient Data

Age: 25 years
Gender: Male

A large subcapsular liver hematoma is identified measuring approximately 14.0 x 17.0 x 19.5 cm (w x AP x h), with layering of high and low density suggestive of blood of different ages.

At the anteromedial aspect of the hematoma, there are a few small areas of active contrast extravasation.Marked mass effect on the adjacent liver which now demonstrates a scalloped contour, as well as mild mass effect on the right kidney, superior pole.

A linear hypodensity courses through the right lobe of liver, in the anteroposterior plane, approaching the liver hilum. At the mid portion of this hypodensity a tiny contrast blush is seen adjacent to the middle hepatic vein. A 10 mm linear defect is also seen within the peripheral contour of the right hepatic liver (liver segment VII/ VIII). Large increase in free intraperitoneal fluid.

No further visceral injury identified. No free intraperitoneal gas.


DSA (angiography)

Right hepatic artery super-selection. This showed extensive ill-defined inferior right hepatic lobe hemorrhage, particularly with focal extravasation pooling around the lower margin of segment 6. Given the ill-defined nature of the hemorrhage, the decision was made to perform Gelfoam (rather than coil) embolization of the right hepatic artery to stasis.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.