Acute-onset abdominal pain in a woman in her 30s

Heart. 2019 Feb;105(4):275-322. doi: 10.1136/heartjnl-2018-313691. Epub 2018 Sep 4.

Abstract

Clinical introduction: A woman in her 30s presented to the emergency department with sudden-onset abdominal pain with hypotension and tachycardia. She gave a history of congenital heart disease for which she had previously undergone multiple operations. On examination she demonstrated right upper quadrant tenderness. She underwent an urgent multiphase CT (figure 1A-C).heartjnl;105/4/275/F1F1F1Figure 1(A) Arterial phase coronal CT. (B) Arterial phase axial CT. (C) Portal venous phase axial CT.

Question: What is the underlying liver pathology?Hepatocellular adenomaCholangiocarcinomaHepatocellular carcinomaFocal nodular hyperplasiaHepatoblastoma.

Keywords: Fontan physiology.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / diagnosis*
  • Abdominal Pain / etiology
  • Adult
  • Angiography, Digital Subtraction / methods
  • Carcinoma, Hepatocellular* / blood supply
  • Carcinoma, Hepatocellular* / complications
  • Carcinoma, Hepatocellular* / etiology
  • Carcinoma, Hepatocellular* / pathology
  • Diagnosis, Differential
  • Embolization, Therapeutic / methods*
  • Female
  • Fontan Procedure / adverse effects*
  • Heart Defects, Congenital / surgery*
  • Hemoperitoneum* / diagnostic imaging
  • Hemoperitoneum* / etiology
  • Hemoperitoneum* / physiopathology
  • Hemoperitoneum* / therapy
  • Hepatic Artery / diagnostic imaging
  • Humans
  • Liver Cirrhosis* / diagnosis
  • Liver Cirrhosis* / etiology
  • Liver Neoplasms* / blood supply
  • Liver Neoplasms* / complications
  • Liver Neoplasms* / etiology
  • Liver Neoplasms* / pathology
  • Rupture, Spontaneous
  • Tomography, X-Ray Computed / methods