36-year-old man with gunshot injury

 

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Doctor's Information

Name : Hamidreza
Family :Haghighatkhah
Affiliation : ----------------
Academic Degree: ----------------
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Mani Armand

 

Patient's Information

Gender : Male
Age : 36

 

Case Section

Abdominal Imaging

 

Clinical Summary

36-year-old man with gunshot injury

 

 

Imaging Procedures and Findings

CT images show a small mass in right hepatic lobe whose pattern of enhancement is completely similar to abdominal aorta, so the lesion is most probably a pseudoaneurysm which is surrounded by hematoma. The presence of air in hematoma represents infection. A subcapsular hematoma is also evident.

 

Discussion

The liver and spleen are the most frequently injured organs in acceleration or deceleration trauma, such as motor vehicle accidents, and direct penetrating injuries of the abdomen. Trauma to the liver and spleen is often associated with an overall unstable hemodynamic state. The right hepatic lobe is most commonly affected, with subcapsular hematoma formation and direct parenchymal compression, parenchymal contusions or lacerations, or rupture of the biliary tree and the subsequent formation of bilomas. Hemorrhage into the biliary tree can be identified by the typical appearance of blood on MDCT and MRI. Multiplanar reformations of high-resolution, cross-sectional imaging data sets are essential to detect complex parenchymal injuries; in particular, parenchymal tears originating in the region of the bare area can be difficult to detect because they follow the hepatic venous distribution .

 

Final Diagnosis

Hepatic branch pseudoaneurysm and infected hematoma

 

References

CT and MR imaging of the whole body / [edited by] John R. Haaga ... jet al.].-5th ed

 

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