Subcapsular hepatic collections: Where can they come from?

Congress:

ECR 2019

Poster Number:

C-0374

Type:

Educational Exhibit

Keywords:

Abdomen, Anatomy, Emergency, CT, Ultrasound, Complications, Localisation, Fistula, Infection, Inflammation

Authors:

M. Fdez. del Castillo Ascanio, D. Eiroa, N. Núñez Vila, C. A. Marichal Hernández, Y. El Khatib Ghzal, S. Benítez Rivero, V. Pantoja Ortiz, S. Garrido Carrasco; Santa Cruz de Tenerife/ES

DOI:

10.26044/ecr2019/C-0374

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-0374

Fig. 1: Anatomical perihepatic space. The liver capsule is composed of two adherent...

Fig. 2: Pathways of communication between the gastric, duodenal and pancreatic regions...

Fig. 3: Diagram showing what happens and where the bile fluid collects when the...

Fig. 4: Sagittal section showing how the vesicular fundus is entirely covered by the...

Learning objectives

To recognize subcapsular hepatic collections as well as to define their possible origins. Traumatic, infectious, inflammatory, infiltrative and metastatic disease are some of the aetiologies that can result in subcapsular hepatic collections.

Background

Subcapsular hepatic collections may arise from a variety of sources. An understanding of the anatomy of the fascial structures is important when interpreting imaging studies, such as computed tomography (CT), and correctly diagnosing such fluid collections. The liver capsule is composed of two adherent layers (figure 1): a thick fibrous inner layer, Glisson’s capsule, which covers the entire surface of the liver, and an outer serous layer that is derived from the visceral peritoneum. The subcapsular space is a potential space that is deep to...

Findings and procedure details

We want to demonstrate through clinical cases that many of the hepatic subcapsular collections come from a problem in the pancreatic duct, bile duct/gallbladder and gastro-duodenal region. Inflammatory/infectious conditions (figures 4, 5, 6, 7, 8, 9, 10) A wide spectrum of infectious and inflammatory diseases may involve the hepatic capsular and subcapsular regions by way of peritoneal, hematogenous, biliary and perihepatic ligamentous routes. Although the liver capsule is not visible at CT, it becomes visible in the presence of liver disease (1). The gallbladder is...

Conclusion

If you open your mind and look for a hole when you find a subcapsular collection around the liver, your diagnosis will probably be helpful for the surgeon and the patient outcome.

Personal information

Contact details: - M. Fdez. del Castillo Ascanio. [email protected]. HUNSC. Santa Cruz de Tenerife - D. Eiroa Gutierrez. [email protected]. HUNSC.Santa Cruz de Tenerife - N. Núñez Vila. [email protected]. Santa Cruz de Tenerife - C. A. Marichal Hernández. [email protected]. Santa Cruz de Tenerife - Y. El Khatib Ghzal. [email protected]. Santa Cruz de Tenerife - S. Benítez Rivero. [email protected]. Santa Cruz de Tenerife - V. Pantoja Ortiz. [email protected]. Santa Cruz de Tenerife - S. Garrido Carrasco. [email protected]. Santa Cruz de Tenerife

References

1. JunWoo Lee, Suk Kim, SangWook Kwack, ChangWon Kim, TaeYong Moon et al. Hepatic Capsular and Subcapsular Patholog- ic Conditions: Demon- stration with CT and MR Imaging. RadioGraphics 2008; 28:1307–1323. 2.https://radiopaedia.org/articles/liver https://radiopaedia.org/articles/gallbladder 3. SukKim, TaeUnKim, JunWooLee, TaeHongLee, Suck Hong Lee, Tae Yong Jeon et al. The Perihepatic Space: Comprehensive Anatomy and CT Features of Pathologic Conditions.RadioGraphics2007;27:129–143. 4.W. Yeh, S. Kim, N. K. Lee, J.-H. Lee, T. H. H. Lee, S. H. Lee, J. Tae Yong;Busan/KP,Pusan. The perihepatic space: Comprehensive anatomy and CT imaging of pathologic...