CEUS for characterization of post-CPR subcapsular liver injury in a potential organ donor

Post-cardiopulmonary resuscitation (CPR) liver trauma is a rare complication that can be difficult to identify when the lesion is subcapsular and small in volume. We describe the case of a 52-year-old man, a candidate for organ donation after out-of-hospital cardiac arrest, in whom abdominal computed tomography revealed a non-conclusive hypodense hepatic area. Contrast-enhanced ultrasound (CEUS) revealed a subcapsular avascular zone with a thin peripheral hypervascular rim, consistent with post-cardiopulmonary resuscitation (CPR) liver contusion/hematoma. CEUS is crucial for lesion characterization in the context of decision-making for organ donation, highlighting its role as a problem-solving technique in the evaluation of abdominal trauma in hemodynamically stable patients.