A 19 year old woman presents with LUQ pain post minor trauma. Your registrar comes to you with this clip concerned they have found a supcapsular splenic haematoma. What do you think?
Describe and interpret these scans
Image 1: LUQ view.
The spleen is clearly and completely demonstrated with homogeneous fine grey echotexture. Over the greater curvature (convex border) of the spleen a more hypoechoic tissue is seen, with small echobright foci.
This is the left lobe of the liver which is entirely normal but extends in this case to “wrap around” the spleen. Hence the term “wrap around liver”.
Wrap around liver – normal variant.
Variants in normal anatomy are common and can cause confusion. An elongated left lobe of the liver may drap over the spleen, and this is more common in women. Confusion with subcapsular haematoma is prevented by being aware of this normal variant.
It is also known as the “beaver tail liver” and “sliver of liver”.
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An Emergency physician based in Perth, Western Australia. Professionally my passion lies in integrating advanced diagnostic and procedural ultrasound into clinical assessment and management of the undifferentiated patient. Sharing hard fought knowledge with innovative educational techniques to ensure knowledge translation and dissemination is my goal. Family, wild coastlines, native forests, and tinkering in the shed fills the rest of my contented time. | SonoCPD | Ultrasound library | Top 100 | @thesonocave |