[Contrast enhanced ultrasound improves detection and quantification of intra-abdominal bleeding]

A 71-year-old man had a coarse needle biopsy performed. After the biopsy symptoms of abdominal bleeding were deteced. An acute ultrasound examination was performed as Focussed Assessment with Sonography in Trauma (FAST). The findings were inconclusive and a Contrast Enhanced Ultrasound (CEUS) was carried out. CEUS immediately demonstrated as well a rim around the liver with clear borders as a large amount of abdominal fluid. Upon these findings immediate surgery was performed. CEUS improves the contrast between areas with and without perfusion, which enhance the presence of haemorrhagic fluid, independently of the fluid's echo-pattern. CEUS seems to be a fast and valuable extension to FAST.