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 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 RLL showing the hepatic collection adjacent to the main portal vein Spectral Doppler of the patent hepatic vein Microvascular imaging (MVI) showing the patent hepatic veins adjacent to the hepatic collection Axial CT showing the hepatic collection Coronal CT showing the hepatic collection Axial CT post pigtail drain insertion Intrahepatic collection in the transplant liver Keywords Published on: November 25, 2024
