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Gastrointestinal
Diagnosis
Liver
Vascular Disorders
Hepatic Infarction
Hepatic Infarction
Atif Zaheer, MD; Michael P. Federle, MD, FACR
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15
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Liver infarction

            • Definitions

              • Area of coagulation necrosis due to local ischemia resulting from obstruction of circulation, most commonly by thrombus or embolus

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Shindo D et al: The findings of the contrast-enhanced CT and risk factors for hepatic infarction after pancreatoduodenectomy. Jpn J Radiol. 38(6):547-52, 2020
                                            2. Li C et al: Hepatic infarction caused by antiphospholipid syndrome secondary to systemic lupus erythematosus. J Rheumatol. 46(7):755-6, 2019
                                            3. Liu GP et al: Acute liver failure and infarction complicating TIPS placement. Radiol Case Rep. 14(7):876-9, 2019
                                            4. Mills A et al: Imaging features of hepatic arterial and venous flow abnormalities. Clin Liver Dis (Hoboken). 11(1):27-32, 2018
                                            5. Maruyama M et al: Hepatic infarction complicated with acute pancreatitis precisely diagnosed with gadoxetate disodium-enhanced magnetic resonance imaging. Intern Med. 53(19):2215-21, 2014
                                            6. Chou MM et al: Extensive hepatic infarction in severe preeclampsia as part of the HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets): evolution of CT findings and successful treatment with plasma exchange therapy. Taiwan J Obstet Gynecol. 51(3):418-20, 2012
                                            7. Cho SK et al: Ischemic liver injuries after hepatic artery embolization in patients with delayed postoperative hemorrhage following hepatobiliary pancreatic surgery. Acta Radiol. 52(4):393-400, 2011
                                            8. Choi SH et al: Hepatic arterial injuries in 3110 patients following percutaneous transhepatic biliary drainage. Radiology. 261(3):969-75, 2011
                                            9. Ebert EC et al: Gastrointestinal and hepatic manifestations of rheumatoid arthritis. Dig Dis Sci. 56(2):295-302, 2011
                                            10. Ebert EC et al: Gastrointestinal and hepatic manifestations of systemic lupus erythematosus. J Clin Gastroenterol. 45(5):436-41, 2011
                                            11. Letoublon C et al: Hepatic arterial embolization in the management of blunt hepatic trauma: indications and complications. J Trauma. 70(5):1032-6; discussion 1036-7, 2011
                                            12. Shah PA et al: Hepatic gas: widening spectrum of causes detected at CT and US in the interventional era. Radiographics. 31(5):1403-13, 2011
                                            13. Wallis A et al: Failure to thrive: an unexpected finding after Whipple's resection. Image 1: extensive hepatic infarction: an extremely rare complication of Whipple's resection. Gastroenterology. 140(7):e1-2, 2011
                                            14. Stewart BG et al: Imaging and percutaneous treatment of secondarily infected hepatic infarctions. AJR Am J Roentgenol. 190(3):601-7, 2008
                                            15. Giovine S et al: Retrospective study of 23 cases of hepatic infarction: CT findings and pathological correlations. Radiol Med (Torino). 111(1):11-21, 2006
                                            16. Fujiwara H et al: Hepatic infarction following abdominal interventional procedures. Acta Med Okayama. 58(2):97-106, 2004
                                            17. Hou SK et al: Hepatic portal venous gas: clinical significance of computed tomography findings. Am J Emerg Med. 22(3):214-8, 2004
                                            18. Blachar A et al: Acute fulminant hepatic infection causing fatal "emphysematous hepatitis": case report. Abdom Imaging. 27(2):188-90, 2002
                                            19. Mayan H et al: Fatal liver infarction after transjugular intrahepatic portosystemic shunt procedure. Liver. 21(5):361-4, 2001
                                            20. Quiroga S et al: Complications of orthotopic liver transplantation: spectrum of findings with helical CT. Radiographics. 21(5):1085-102, 2001
                                            21. Kim T et al: Infarcted regenerative nodules in cirrhosis: CT and MR imaging findings with pathologic correlation. AJR Am J Roentgenol. 175(4):1121-5, 2000
                                            22. Wallace S et al: Hepatic chemoembolization: clinical and experimental correlation. Acta Gastroenterol Belg. 63(2):169-73, 2000
                                            23. Smith GS et al: Hepatic infarction secondary to arterial insufficiency in native livers: CT findings in 10 patients. Radiology. 208(1):223-9, 1998
                                            24. Holbert BL et al: Hepatic infarction caused by arterial insufficiency: spectrum and evolution of CT findings. AJR Am J Roentgenol. 166(4):815-20, 1996
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Synonyms

                                                        • Liver infarction

                                                      • Definitions

                                                        • Area of coagulation necrosis due to local ischemia resulting from obstruction of circulation, most commonly by thrombus or embolus

                                                      IMAGING

                                                      • General Features

                                                        • CT Findings

                                                          • MR Findings

                                                            • Ultrasonographic Findings

                                                              • Nuclear Medicine Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Shindo D et al: The findings of the contrast-enhanced CT and risk factors for hepatic infarction after pancreatoduodenectomy. Jpn J Radiol. 38(6):547-52, 2020
                                                                                      2. Li C et al: Hepatic infarction caused by antiphospholipid syndrome secondary to systemic lupus erythematosus. J Rheumatol. 46(7):755-6, 2019
                                                                                      3. Liu GP et al: Acute liver failure and infarction complicating TIPS placement. Radiol Case Rep. 14(7):876-9, 2019
                                                                                      4. Mills A et al: Imaging features of hepatic arterial and venous flow abnormalities. Clin Liver Dis (Hoboken). 11(1):27-32, 2018
                                                                                      5. Maruyama M et al: Hepatic infarction complicated with acute pancreatitis precisely diagnosed with gadoxetate disodium-enhanced magnetic resonance imaging. Intern Med. 53(19):2215-21, 2014
                                                                                      6. Chou MM et al: Extensive hepatic infarction in severe preeclampsia as part of the HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets): evolution of CT findings and successful treatment with plasma exchange therapy. Taiwan J Obstet Gynecol. 51(3):418-20, 2012
                                                                                      7. Cho SK et al: Ischemic liver injuries after hepatic artery embolization in patients with delayed postoperative hemorrhage following hepatobiliary pancreatic surgery. Acta Radiol. 52(4):393-400, 2011
                                                                                      8. Choi SH et al: Hepatic arterial injuries in 3110 patients following percutaneous transhepatic biliary drainage. Radiology. 261(3):969-75, 2011
                                                                                      9. Ebert EC et al: Gastrointestinal and hepatic manifestations of rheumatoid arthritis. Dig Dis Sci. 56(2):295-302, 2011
                                                                                      10. Ebert EC et al: Gastrointestinal and hepatic manifestations of systemic lupus erythematosus. J Clin Gastroenterol. 45(5):436-41, 2011
                                                                                      11. Letoublon C et al: Hepatic arterial embolization in the management of blunt hepatic trauma: indications and complications. J Trauma. 70(5):1032-6; discussion 1036-7, 2011
                                                                                      12. Shah PA et al: Hepatic gas: widening spectrum of causes detected at CT and US in the interventional era. Radiographics. 31(5):1403-13, 2011
                                                                                      13. Wallis A et al: Failure to thrive: an unexpected finding after Whipple's resection. Image 1: extensive hepatic infarction: an extremely rare complication of Whipple's resection. Gastroenterology. 140(7):e1-2, 2011
                                                                                      14. Stewart BG et al: Imaging and percutaneous treatment of secondarily infected hepatic infarctions. AJR Am J Roentgenol. 190(3):601-7, 2008
                                                                                      15. Giovine S et al: Retrospective study of 23 cases of hepatic infarction: CT findings and pathological correlations. Radiol Med (Torino). 111(1):11-21, 2006
                                                                                      16. Fujiwara H et al: Hepatic infarction following abdominal interventional procedures. Acta Med Okayama. 58(2):97-106, 2004
                                                                                      17. Hou SK et al: Hepatic portal venous gas: clinical significance of computed tomography findings. Am J Emerg Med. 22(3):214-8, 2004
                                                                                      18. Blachar A et al: Acute fulminant hepatic infection causing fatal "emphysematous hepatitis": case report. Abdom Imaging. 27(2):188-90, 2002
                                                                                      19. Mayan H et al: Fatal liver infarction after transjugular intrahepatic portosystemic shunt procedure. Liver. 21(5):361-4, 2001
                                                                                      20. Quiroga S et al: Complications of orthotopic liver transplantation: spectrum of findings with helical CT. Radiographics. 21(5):1085-102, 2001
                                                                                      21. Kim T et al: Infarcted regenerative nodules in cirrhosis: CT and MR imaging findings with pathologic correlation. AJR Am J Roentgenol. 175(4):1121-5, 2000
                                                                                      22. Wallace S et al: Hepatic chemoembolization: clinical and experimental correlation. Acta Gastroenterol Belg. 63(2):169-73, 2000
                                                                                      23. Smith GS et al: Hepatic infarction secondary to arterial insufficiency in native livers: CT findings in 10 patients. Radiology. 208(1):223-9, 1998
                                                                                      24. Holbert BL et al: Hepatic infarction caused by arterial insufficiency: spectrum and evolution of CT findings. AJR Am J Roentgenol. 166(4):815-20, 1996