Contrast-enhanced ultrasonography (CEUS) reveals active bleeding into an abdominal hematoma in a patient with ongoing subcutaneous injections

Abstract

A 95-year-old woman with metastasizing bronchial carcinoma presents with left inguinal pain. The referring physician would like to exclude an inguinal hernia and a deep vein thrombosis due to her precondition of essential thrombocythemia. Conventional ultrasound excluded the presence of a deep vein thrombosis yet showed a 6 cm × 5 cm hematoma distal of the left m. rectus abdominis. The subsequently performed color Doppler examination excluded a pseudoaneurysm but could not preclude active bleeding. Eventually, CEUS showed contrast-pooling within the hematoma as a sign of active extravasation, suggesting ongoing bleeding.

Zusammenfassung

Eine 95-jährige Frau mit metastasierendem Bronchialkarzinom stellt sich mit Schmerzen in der linken Leistengegend vor. Der überweisende Arzt möchte einen Leistenbruch und eine tiefe Beinvenenthrombose ausschließen, da die Patientin an einer essentiellen Thrombozythämie leidet. Der konventionelle Ultraschall schloss das Vorliegen einer tiefen Venenthrombose aus, jedoch zeigte sich ein 6 cm × 5 cm großes Hämatom distal des linken M. rectus abdominis. Die anschließend durchgeführte Farbdoppleruntersuchung konnte ein Pseudoaneurysma ausschließen jedoch nicht eine aktive Blutung. In der CEUS-Untersuchung stellte sich schließlich eine Kontrastmittelanreicherung innerhalb des Hämatoms als Zeichen einer aktiven Blutung dar.

Schlüsselwörter

CEUS - Hämatom - Blutung

Keywords

CEUS - hematoma - active bleeding

Publication History

Received: 02 July 2021

Accepted after revision: 09 October 2021

Article published online:
18 January 2022

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