Sentinel clot sign in hemoperitoneum

Ilyas, Mohd; Bashir, Muiez; Robbani, Irfan; Rasool, Sheikh Riaz; Shera, Faiz Altaf; Hamid, Imran

doi:10.1007/s00261-019-01926-3

Cited by 8 publications

(5 citation statements)

References 3 publications

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“…Moreover, in the case of intraluminal hemorrhages, the extravasation may assume a declivous position in the intestinal lumen or a more irregular shape due to the peristalsis. The so-called “sentinel clot sign”, defined as a hyperdense clot observable near the postoperative bleeding source, may be documented when recent bleeding has occurred but has stopped at the time of CECT [47] ( Fig. 3 ).…”

Section: Post-surgical Bleedingmentioning

confidence: 99%

Cross-sectional imaging after pancreatic surgery: The dialogue between the radiologist and the surgeon

Maino,

Cereda,

Franco

et al. 2024

European Journal of Radiology Open

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Section: Post-surgical Bleedingmentioning

confidence: 99%

Cross-sectional imaging after pancreatic surgery: The dialogue between the radiologist and the surgeon

Maino,

Cereda,

Franco

et al. 2024

European Journal of Radiology Open

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“…Sentinel clot sign ( Figure 2 , Figure 3 and Figure 4 ). This sign is one of the most suggestive findings of organ injury and has a role in the diagnosis of occult hemorrhages [ 96 ]. Blood with the highest density is commonly seen nearby the hemorrhage site, while less attenuating portions of hematoma are observed more distally.…”

Section: Ct Findingsmentioning

confidence: 99%

“…Recent clots have a higher attenuation value than non-coagulated blood or chronic hemorrhage. The presence of a clot with a higher density near the tumoral site identifies the initial hemorrhagic focus [ 96 ]. This sign is also useful for undiagnosed small tumors and is similar to findings described in visceral traumas [ 97 ].…”

Section: Ct Findingsmentioning

confidence: 99%

Spontaneously Ruptured Hepatocellular Carcinoma: Computed Tomography-Based Assessment

et al. 2023

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Spontaneously ruptured hepatocellular carcinoma (SRHCC) is an uncommon and life-threatening complication in patients with hepatocellular carcinoma (HCC). It is usually associated with chronic liver disease and has a poor prognosis with a high mortality rate during the acute phase. SRHCC can cause a severe and urgent condition of acute abdomen disease and requires a correct diagnosis to achieve adequate treatment. Clinical presentation is related to the presence of hemoperitoneum, and abdominal pain is the most common symptom (66–100% of cases). Although the treatment approach is not unique, trans-arterial (chemo)embolization (TAE/TACE) followed by staged hepatectomy has shown better results in long-term survival. A multi-phase contrast-enhanced CT (CECT) scan is a pivotal technique in the diagnosis of SRHCC due to its diagnostic accuracy and optimal temporal resolution. The correct interpretation of the main CT findings in SRHCC, such as active contrast extravasation and the sentinel clot sign, is fundamental for a prompt and correct diagnosis. Furthermore, CT also plays a role as a post-operative control procedure, especially in patients treated with TAE/TACE. Therefore, a multi-phase CECT scan should be the diagnostic tool of choice in SRHCC since it suggests an immediate need for treatment with a consequent improvement in prognosis.

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“…To assess active bleeding and to identify bleeding causes, a multiphasic CT evaluation is mandatory ( Figure 6 ) [ 149 , 150 , 151 , 152 , 153 , 154 ]. During pre-contrast CT evaluation, a blood collection with an attenuation of 30–45 HU could be found [ 155 , 156 , 157 , 158 , 159 , 160 , 161 , 162 , 163 , 164 , 165 ].…”

Section: Non Anatomic Liver Resectionmentioning

confidence: 99%

Imaging Features of Main Hepatic Resections: The Radiologist Challenging

Cutolo

Fusco

Simonetti

et al. 2023

JPM

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Liver resection is still the most effective treatment of primary liver malignancies, including hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA), and of metastatic disease, such as colorectal liver metastases. The type of liver resection (anatomic versus non anatomic resection) depends on different features, mainly on the type of malignancy (primary liver neoplasm versus metastatic lesion), size of tumor, its relation with blood and biliary vessels, and the volume of future liver remnant (FLT). Imaging plays a critical role in postoperative assessment, offering the possibility to recognize normal postoperative findings and potential complications. Ultrasonography (US) is the first-line diagnostic tool to use in post-surgical phase. However, computed tomography (CT), due to its comprehensive assessment, allows for a more accurate evaluation and more normal findings than the possible postoperative complications. Magnetic resonance imaging (MRI) with cholangiopancreatography (MRCP) and/or hepatospecific contrast agents remains the best tool for bile duct injuries diagnosis and for ischemic cholangitis evaluation. Consequently, radiologists should be familiar with the surgical approaches for a better comprehension of normal postoperative findings and of postoperative complications.

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Sentinel clot sign in hemoperitoneum

Cited by 8 publications

References 3 publications

Cross-sectional imaging after pancreatic surgery: The dialogue between the radiologist and the surgeon

Cross-sectional imaging after pancreatic surgery: The dialogue between the radiologist and the surgeon

Spontaneously Ruptured Hepatocellular Carcinoma: Computed Tomography-Based Assessment

Imaging Features of Main Hepatic Resections: The Radiologist Challenging

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