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Chinese Journal of Hepatic Surgery(Electronic Edition) ›› 2025, Vol. 14 ›› Issue (01): 113-117. doi: 10.3877/cma.j.issn.2095-3232.2025021

• Clinical Researches • Previous Articles     Next Articles

Application of contrast-enhanced ultrasound in diagnosis of liver rupture: reflection on one case of liver rupture from Xizang

Lei Tan1, Dengdi Wang2, Hao Zhang3, Zhuoma Danzeng2, Yi Long2, Zeqian Wu4,()   

  1. 1.Department of Ultrasound, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
    2.Department of Function, Chaya County People's Hospital, Chaya 854300, China
    3.Department of Surgery, Chaya County People's Hospital, Chaya 854300, China
    4.Department of Infectious Disease, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
  • Received:2024-11-18 Online:2025-02-10 Published:2025-01-23
  • Contact: Zeqian Wu

Abstract:

Objective

To evaluate the clinical value of contrast-enhanced ultrasound (CEUS)in the diagnosis of liver rupture in Xizang, China.

Methods

On November 22, 2022, a 47-year-old female patient from Xizang was admitted to the hospital due to "the right upper abdominal pain for 1 h after being injured by the cattle horn".Physical examination revealed stable vital signs, a 5-cm transverse wound in the right upper abdomen, subcutaneous tissue exposure and blood oozing.The muscles of the right upper abdomen were tense, positive for tenderness.The patient had percussion tenderness of the liver area.Ultrasound and CEUS diagnosis by color Doppler ultrasound to confirm the incidence of liver rupture and active bleeding, providing evidence for subsequent clinical diagnosis and treatment.

Results

Abdominal ultrasound showed that the liver size and morphology were normal, with smooth surface and even echo in liver parenchyma.A patchy mixed echo area, approximately 30 mm×22 mm in size, could be seen beneath the S5 capsule in the right lobe.The possibility of liver rupture and hematocele in the abdominal cavity was considered.CEUS was performed by injection of 1.5 ml contrast agent through the elbow vein.The abnormal echo area of S5 liver segment was observed for the first time, and there was no enhancement in the arterial,portal venous and delayed phases, respectively.Secondary CEUS was conducted to observe hepatic capsule and peritoneal effusion and detect no evident microbubble overflow.Combined with CEUS, the diagnosis of liver rupture was made.No evident signs of active bleeding were found.Ultrasound-guided catheter drainage of peritoneal effusion was performed, and dark-red bloody fluid was drained.Subsequently, the patient lay down for resting, anti-infection and symptomatic treatment.The patient showed stable vital signs and was discharged.At 3 weeks after discharge, color Doppler ultrasound showed that the echo of liver parenchyma was uniform, the echo area beneath liver capsule was significantly decreased, and no evident dark fluid area was found.The patient restored normal life without any discomfort.

Conclusions

CEUS is a timely, reliable and convenient diagnostic tool for liver rupture in Xizang, which is worthy of widespread application at grassroot-level hospitals.

Key words: Liver rupture, Contrast-enhanced ultrasonography (CEUS), Diagnosis

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