Case courtesy of Dr Sachintha Hapugoda, Radiopaedia.org, rID: 51390

Grade 1

Small liver laceration – perihepatic hematoma and hemoperitoneum

35 male hemoperitoneum
Small laceration, perihepatic hematoma and hemoperitoneum
Ashley Davidoff
133866
Grade II
CT Small focal laceration in segment IV A
Ashley Davidoff
15891
Grade II

Subcapsular hematoma involving 10-50% surface area

CT Subcapsular Hematoma
Ashley Davidoff
15883
Grade II
Grade II

<10cms diameter

16F liver trauma
Bear Claw Lacerations
Ashley Davidoff
133855
Grade II

diameter <10cms

CT Intraparenchymal Hematoma
CT Subcapsular Hematoma
Ashley Davidoff
02130b
Grade II with Intraparenchymal Hematoma and hemorrhage in to the Gallbladder Wall
38f
Grade II liver injury and hematoma with hemorrhage into the gallbladder
Ashley Davidoff
01638tcv
38f
Grade II liver injury and hematoma with hemorrhage into the gallbladder
Ashley Davidoff
01640tcv
38f
Grade II liver injury and hematoma with hemorrhage into the gallbladder
Ashley Davidoff
01642tcv
38f
Grade II liver injury and hematoma with hemorrhage into the gallbladder
Ashley Davidoff
01643tcv
38f
Grade II liver injury and hematoma with hemorrhage into the gallbladder
Ashley Davidoff
01646tcvb02
38f
Grade II liver injury and hematoma with hemorrhage into the gallbladder
Ashley Davidoff
01646tcvb
Grade II with Arterial Injury hemobilia and Requiring Arterial Embolisation
Intraparenchymal contusion, laceration and hemorrhage
Ashley Davidoff
000115

00113b01.jpg

1 day later presents with hematemesis and CT shows hemobilia
Ashley Davidoff
000113b01
Angiogram shows abnormal focal aneurysm or pseudoaneurysm
Ashley DAvidoff MD
00116
Angiogram shows abnormal focal aneurysm or pseudoaneurysm post embolisation
Ashley Davidoff
133880.8

 

1 week later the laceraion and contusion showed liquifaction with a hematocrit level. No further hematemesis
Ashley DAvidoff MD
00117c
Grade III
Intraparenchymal hematoma each <10cms diameter but overall left lobe disease is > than 10cms

Left Lobe Subcapsular hematoma also >10cms

CT Multifocal contusions left lobe with hematocrit level and hemoperitoneum
Ashley Davidoff
15886b
CT Multifocal Contusions Left Lobe with hematocrit level
Ashley Davidoff
15886b01
Grade III

>10cms in diameter

US Hematoma
Ashley Davidoff
00418
Grade 3 with classic Bear Claw Deformity
r Claw Lacerations
Ashley DAvidoff MD
15888b
Grade 3

Interesting lesion The hemorrhage is >10cms and there are extensive fine long linear lacerations involving both the left and right lobes

Intraparenchymal contusion, laceration and hemorrhage
Ashley Davidoff
03821

Narrow Windows showing hemorrhage

Intraparenchymal contusion, laceration and hemorrhage
Ashley Davidoff
03816
Grade IV

25-75% lobe disruption

CT Multifocal Contusions Segments, !V, VI and VII
Ashley Davidoff
15885
Grade V

>75% lobe disruption

29 male MVA  trauma
Extensive liver contusion and laceration involving > 75% of the right lobe associated with hemoperitoneum
Ashley Davidoff
30766
29 male trauma
Extensive liver contusion and laceration (bear claw ) involving > 75% of the right lobe associated with hemoperitoneum
Ashley Davidoff
30767
Grade V

>75% lobe disruption

Liver Trauma
Contusion and lacerations with intraparenchymal hematoma as well as subcapsular hematoma
Ashley Davidoff
03813b
Liver Trauma
Contusion and lacerations with intraparenchymal hematoma as well as subcapsular hematoma
Ashley Davidoff
03814b