RETURN TO ABSTRACT LISTING


Background
Penetrating liver trauma, often resulting from gunshot or stab wounds, can be difficult to accurately and completely evaluate on diagnostic imaging, which necessitates an imaging strategy that is tailored to the specific injury. Currently, however, the majority of literature focuses on imaging evaluation of blunt rather than penetrating liver trauma. This exhibit aims to illustrate the spectrum of imaging findings in penetrating liver trauma while describing the different imaging modalities used to evaluate the injury and their comparative advantages.

Educational Goals / Teaching Points
This exhibit aims to convey the complex nature of penetrating liver trauma while describing the challenges inherent in using imaging to accurately and completely characterize the injury. It will also provide a comprehensive overview of the liver's anatomy, vascular supply, and relationships with adjacent organs to enhance attendees' understanding of potential injury patterns. Additionally, the exhibit will explore potential complications arising from penetrating liver trauma including hemorrhage, complex vascular injury, bile leak, and infection by providing imaging examples of each. Lastly, the exhibit will detail the pivotal role that imaging plays in evaluating penetrating liver trauma by highlighting the comparative strengths and unique advantages of each modality in classifying the injury. Ultimately, the exhibit will use a case-based approach to improve attendees' proficiency in interpreting imaging findings related to penetrating liver trauma including their ability to identify specific injuries and complications.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This overview describes in detail the comparative advantages of different diagnostic imaging modalities in evaluating penetrating liver trauma while providing case-based examples of the different imaging findings and injury patterns that can be encountered. Contrast-enhanced CT allows for rapid assessment of parenchymal and vascular injury as well as detection of active hemorrhage. MRI offers superior soft tissue contrast and multiplanar capabilities. Ultrasound facilitates real-time evaluation of vascular structures and alterations in blood flow dynamics that may result from complex vascular injury. Nuclear medicine imaging allows for sensitive detection of bile leaks resulting from traumatic injury to the liver parenchyma or biliary system.

Conclusion
Having a facile understanding of common patterns of injury, pertinent imaging findings, and the respective strengths of the different imaging modalities allow the imager to make a comprehensive assessment of penetrating liver trauma on a case-by-case basis.