Case Study: Accident Aftermath

Think you can make the diagnosis? Put your POCUS skills to the test and see if you can solve this case study.

A 35-year-old female was brought to the emergency department with a history of being involved in a motor vehicle accident at high speeds. The following image was obtained in the right upper quadrant.

 

What is the diagnosis?

A. No free fluid seen in the abdominal cavity
B. Free fluid seen in the Morison’s pouch and near the inferior edge of the liver
C. Pneumoperitoneum

 

 

Explanation

A small amount of anechoic (black) fluid is seen in the Morison’s pouch. Larger amount is seen near the tip of the liver. Always correlate clinically. The findings indicate fluid. When correlated with the history and other physical findings it may suggest evidence of internal bleeding. DPL can also be done to confirm the true nature of the fluid.

 

References

  1. https://doi.org/10.1186/s40560-016-0175-y

 

 


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