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.
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References
- Randomized controlled clinical trial of point-of-care, limited ultrasonography for trauma in the emergency department: the first sonography outcomes assessment program trial.Ann Emerg Med. 2006; 48: 227-235
Nagdev A, J Racht, The “gastric fluid” sign: an unrecognized false-positive finding during focused assessment for trauma examinations. Am J Emerg Med, 2008;26(5): 630 e5-7.
- Left lobe of the liver draping around the spleen: a pitfall in computed tomography diagnosis of perisplenic hematoma.J Comput Tomogr. 1984; 8: 261-267
- Pseudo perisplenic “fluid collections”: a clue to normal liver and spleen echogenic texture.J Ultrasound Med. 1986; 5: 397-400
- Left lobe of the liver mimicking perisplenic collections.J Clin Ultrasound. 1986; 14: 697-701
- Ultrasound detection of blunt splenic injury.Injury. 2001; 32: 95-103
Article Info
Publication History
Published online: January 06, 2014
Accepted:
December 19,
2013
Received:
December 18,
2013
Footnotes
☆Sources of support: None.
☆☆Name of organization and date of assembly if the article has been presented: None.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
