naa a22 4500 510813933 CHVBK 20180411083456.0 cr unu---uuuuu 180411e20130801xx s 000 0 eng 10.1007/s12328-013-0398-6 doi (NATIONALLICENCE)springer-10.1007/s12328-013-0398-6 Usefulness of contrast-enhanced ultrasonography in the diagnosis of ruptured hepatocellular carcinoma [Elektronische Daten] [Kazue Shiozawa, Manabu Watanabe, Takashi Ikehara, Yasushi Matsukiyo, Koji Ishii, Yoshinori Igarashi, Yasukiyo Sumino] The identification of bleeding sites of ruptured hepatocellular carcinoma (HCC) is important for immediate treatment. We experienced a case of ruptured HCC readily treated with transarterial embolization (TAE) after identification of the bleeding site using contrast-enhanced ultrasonography (CEUS) with Sonazoid. We report the case of a 61-year-old male with multiple HCCs caused by alcohol-related cirrhosis, who was admitted for rapid development of abdominal fullness. The diagnosis was established by hemorrhagic ascites by abdominal paracentesis. No clear extravasation was found on contrast-enhanced computed tomography. CEUS using the re-injection method in the post-vascular phase showed active bleeding from a lesion close to the S5 gallbladder bed. Abdominal angiography was urgently performed. Based on CEUS findings, selective cannulation of the cystic artery was performed. Cystic angiography findings with carbon dioxide showed extravasation. He was treated by TAE. Our case had multiple HCCs, but CEUS was useful for the identification of bleeding sites. The Author(s), 2013 Hepatocellular carcinoma nationallicence Rupture nationallicence Contrast-enhanced ultrasonography nationallicence Sonazoid nationallicence Transarterial embolization nationallicence Shiozawa Kazue Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, 143-8541, Tokyo, Japan aut Watanabe Manabu Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, 143-8541, Tokyo, Japan aut Ikehara Takashi Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, 143-8541, Tokyo, Japan aut Matsukiyo Yasushi Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, 143-8541, Tokyo, Japan aut Ishii Koji Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, 143-8541, Tokyo, Japan aut Igarashi Yoshinori Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, 143-8541, Tokyo, Japan aut Sumino Yasukiyo Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, 143-8541, Tokyo, Japan aut Clinical Journal of Gastroenterology Springer Japan 6/4(2013-08-01), 334-337 1865-7257 6:4<334 2013 6 12328 https://doi.org/10.1007/s12328-013-0398-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12328-013-0398-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Shiozawa Kazue Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, 143-8541, Tokyo, Japan aut NATIONALLICENCE 700 1- Watanabe Manabu Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, 143-8541, Tokyo, Japan aut NATIONALLICENCE 700 1- Ikehara Takashi Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, 143-8541, Tokyo, Japan aut NATIONALLICENCE 700 1- Matsukiyo Yasushi Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, 143-8541, Tokyo, Japan aut NATIONALLICENCE 700 1- Ishii Koji Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, 143-8541, Tokyo, Japan aut NATIONALLICENCE 700 1- Igarashi Yoshinori Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, 143-8541, Tokyo, Japan aut NATIONALLICENCE 700 1- Sumino Yasukiyo Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, 143-8541, Tokyo, Japan aut NATIONALLICENCE 773 0- Clinical Journal of Gastroenterology Springer Japan 6/4(2013-08-01), 334-337 1865-7257 6:4<334 2013 6 12328 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer