Elongated left lobe of the liver mimicking a subcapsular hematoma of the spleen on the focused assessment with sonography for trauma exam

The focused assessment with sonography for trauma examination has assumed the role of initial screening examination for the presence or absence of hemoperitoneum in the patient with blunt abdominal trauma. Sonographic pitfalls associated with the examination have primarily been related to mistaking...

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Bibliographic Details
Published in:The American journal of emergency medicine 2014-07, Vol.32 (7), p.814.e3-814.e4
Main Authors: Jones, Robert, DO, Tabbut, Matthew, MD, Gramer, Diane, RVT
Format: Article
Language:English
Subjects:
Abdomen
Accidents, Traffic
Adult
Collections
Computed tomography
Diagnosis, Differential
Emergency
Emergency medical care
Female
Hematoma - diagnosis
Hematoma - diagnostic imaging
Humans
Injuries
Liver
Liver - abnormalities
Liver - diagnostic imaging
Spleen - diagnostic imaging
Spleen - injuries
Splenic Diseases - diagnosis
Splenic Diseases - diagnostic imaging
Tomography, X-Ray Computed
Ultrasonography
Wounds, Nonpenetrating - diagnosis
Wounds, Nonpenetrating - diagnostic imaging
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Summary:The focused assessment with sonography for trauma examination has assumed the role of initial screening examination for the presence or absence of hemoperitoneum in the patient with blunt abdominal trauma. Sonographic pitfalls associated with the examination have primarily been related to mistaking contained fluid collections with hemoperitoneum. We present a case in which an elongated left lobe of the liver was misdiagnosed as a splenic subcapsular hematoma. It is imperative that emergency physicians and trauma surgeons be familiar with this normal variant of the liver and its associated sonographic appearance on the perisplenic window in order to prevent nontherapeutic laparotomies or embolizations.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2013.12.050