Ultrasonic study of hepatic and splenic traumatic lesions

Traumatic lesions involving the parenchyma of liver and spleen give heterogeneous echo patterns on sonograms. Associated haematomas appear as sonolucent or sonotransparent areas. Subcapsular haematomas appear as peripheral sonolucent or sonotransparent areas. High resolution sectorial real-time ultrasound demonstrates such abnormalities. When examining for splenic or hepatic lesions, associated lesions such as renal contusion, juxta-renal or retroperitoneal haematoma and haemoperitoneum are sought. Haemoperitoneum may be shown in Morrison's pouch, in the vicinity of the spleen (moon-crescent sign) and also in the sac of Douglas. None of the abnormalities is entirely specific for trauma. However, the sensitivity of ultrasound in the evaluation of trauma is sufficient to render other diagnostic procedures such as C.T. and angiography only rarely necessary.