Liver Trauma

  • Etiology: blunt abdominal trauma
  • Imaging: spectrum is contusion / laceration – stellate or bearclaw or fracture / hematoma – subcapsular or intraparenchymal / vascular disruption, hemorrhage can dissect into retroperitoneum, does not always have hemoperitoneum
  • DDX: periportal halo is a mimic of liver trauma and appears as areas of low density surrounding the portal veins, due to fluid accumulation or lymphatic dilation around the portal triads from aggressive fluid resuscitation, not specific for trauma
  • Clinical: posterior segment of right lobe of liver injured most often

Cases of Liver Trauma

CT of liver trauma / liver laceration
Axial CT with contrast of the abdomen shows an area of low density in the right lobe of the liver and a large amount of free fluid in the pelvis.
CT of periportal halo
Axial CT with contrast of the abdomen shows no laceration in the liver and linear low density surrounding the portal venous system.
CT of inhomogenous enhancement of the spleen and liver laceration
Axial CT with contrast of the abdomen shows a stellate area of low density in the right lobe of the liver. The spleen does not have a laceration, instead it demonstrates inhomogenous opacification due to the image being obtained in the arterial phase – note how dense the contrast in the aorta is.
CT of adrenal trauma / adrenal laceration and liver trauma / liver laceration
Axial CT with contrast of the abdomen shows a large amount of fluid in the region of the right adrenal gland and areas of low density in the middle and posterior aspects of the right lobe of the liver.