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Updated on March 18, 2025

Abnormal Intrahepatic Collection of a Liver Transplant

Clinical History

A 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 Description

Ultrasound 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-up

Triple-phase liver CT confirmed the presence of branching fluid attenuation in the right hepatic lobe in keeping with collections.

The hepatic collection was drained.

Sonograms

Right lobe liver with a heterogeneous collection
Right lobe liver with a heterogeneous collection
CDI right lobe liver showing the collection adjacent to the hepatic veins
CDI right lobe liver showing the collection adjacent to the hepatic veins
CDI right lobe liver showing the hepatic collection adjacent to the hepatic veins
CDI right lobe liver showing the hepatic collection adjacent to the hepatic veins
CDI RLL showing the hepatic collection adjacent to the main portal vein
CDI RLL showing the hepatic collection adjacent to the main portal vein
Spectral Doppler of the patent hepatic vein
Spectral Doppler of the patent hepatic vein
Microvascular imaging (MVI) showing the patent hepatic veins adjacent to the hepatic collection
Microvascular imaging (MVI) showing the patent hepatic veins adjacent to the hepatic collection
Axial CT showing the hepatic collection
Axial CT showing the hepatic collection
Coronal CT showing the hepatic collection
Coronal CT showing the hepatic collection
Axial CT post pigtail drain insertion
Axial CT post pigtail drain insertion
Intrahepatic collection in the transplant liver
Intrahepatic collection in the transplant liver

Keywords

Published on: November 25, 2024

Author

Sonohive

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