Abnormal Intrahepatic Collection of a Liver TransplantClinical HistoryA 50-year old man with recurrent history of liver transplantations presented with delirium, diarrhoea, and vomiting. Liver function test was abnormal. Ultrasound was requested as a first line of imaging to assess the biliary tree or other possible cause for symptoms.Case DescriptionUltrasound revealed a large tubular and tortuous heterogeneous hypoechoic area within the liver suggestive of intrahepatic collection. No internal vascularity was observed within the area of abnormality. The hepatic vessels were patent on Doppler interrogation.Diagnosis/ Discussion/ Treatment/ Follow-upTriple-phase liver CT confirmed the presence of branching fluid attenuation in the right hepatic lobe in keeping with collections.The hepatic collection was drained.SonogramsRight lobe liver with a heterogeneous collectionCDI right lobe liver showing the collection adjacent to the hepatic veinsCDI right lobe liver showing the hepatic collection adjacent to the hepatic veinsCDI RLL showing the hepatic collection adjacent to the main portal veinSpectral Doppler of the patent hepatic veinMicrovascular imaging (MVI) showing the patent hepatic veins adjacent to the hepatic collectionAxial CT showing the hepatic collectionCoronal CT showing the hepatic collectionAxial CT post pigtail drain insertionIntrahepatic collection in the transplant liverKeywordsPublished on: November 25, 2024
