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RADIOLOGY: HEPATOBILIARY: Case# 34069: LARGE SUBCAPSULAR HEMATOMA IN THE LIVER DUE TO PERITONEAL LIEOMYOMATOSIS. Acute onset abdominal pain. Previous history of intraperitoneal leiomyomatosis. 1. There has been interval development of a very large subcapsular hematoma in the liver, with marked mass effect upon the right lobe. In addition, extensive irregular low attenuation areas are seen extending into the liver parenchyma chiefly involving right lobe and medial segment. The appearance is most consistent with traumatic laceration of the liver, but no history of trauma has been elicited. THis may represent intraparenchymal extension of hematoma. THere appears to be evidence of active extravasation in the region adjacent to Morisons pouch. 2. Well-defined soft tissue nodules in the periumbilical region are unchanged; however, there has been interval resolution of a solitary, 1.5 cm to 2.0 cm low attenuation nodule in the periumbilical region. Poorly-defined less than or equal to 1 cm nodules are seen in the mesentery and omentum and are unchanged. Interval decrease in the amount of fluid in the pelvis as well as adjacent soft tissue stranding. A small amount of fluid is seen adjacent to the liver. Small right pleural effusion present.

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Peter Anderson
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