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Click 12 year old male with traumatic portacaval fistula. FINDINGS: Axial CT of the abdomen and pelvis in liver window (initial trauma CT). Compare the normally perfused and enhancing left lobe of the liver with the abnormal, devascularized and hypoenhancing right lobe of the liver. Images show also a displaced right 8th rib fracture, which is rotated approximately 180 and displaced laterally. There is abrupt occlusion of central branches of the right portal vein. TECHNIQUE: Siemens Sensation 40, 5mm slice thickness, 150cc Omnipaque 300, kVp 120, mA 295.

Click 12 year old male with traumatic portacaval fistula. FINDINGS: Coronal reformatted CT of the abdomen and pelvis in liver window (initial trauma CT). Compare the normally perfused and enhancing left lobe of the liver with the abnormal, devascularized and hypoenhancing right lobe of the liver. Images show also a displaced right 8th rib fracture, which is rotated approximately 180 and displaced laterally. There is abrupt occlusion of central branches of the right portal vein. TECHNIQUE: Siemens Sensation 40, 5mm slice thickness, 150cc Omnipaque 300, kVp 120, mA 295.

Click 12 year old male with traumatic portacaval fistula. FINDINGS: 2 day follow up CT. Axial CT in portal venous phase demonstrates an abnormal fistulous connection between the portal vein and suprahepatic IVC, with occlusion of the right portal vein branches distal to the shunt. Abrupt occlusion of the right hepatic artery is also evident. Foci of gas are now identified within the necrotic right lobe of the liver. TECHNIQUE: Siemens Sensation 64, multiphase liver CT, kVp 120, mA 345, 5mm slice thickness. Precise contrast type/amount not available.

Click 12 year old male with traumatic portacaval fistula. FINDINGS: 2 day follow up CT. Coronal reformatted CT in portal venous phase demonstrates an abnormal fistulous connection between the portal vein and suprahepatic IVC, with occlusion of the right portal vein branches distal to the shunt. Abrupt occlusion of the right hepatic artery is also evident. Foci of gas are now identified within the necrotic right lobe of the liver. TECHNIQUE: Siemens Sensation 64, multiphase liver CT, kVp 120, mA 345, 5mm slice thickness. Precise contrast type/amount not available.