Contrast-enhanced ultrasonography revealed active thoracic bleeding.
A 61-year-old woman with a hepatocellular carcinoma located in the subphrenic region was treated by radiofrequency ablation (RFA) under artificial pleural effusion. During RFA, B-mode ultrasonography showed a swirling high echoic lesion in the artificial pleural effusion. A real-time scan performed using contrast-enhanced ultrasonography (CEUS) revealed a jet-like extravasation of contrast medium and pooling of microbubbles in the pleural cavity, which were confirmed by angiography. CEUS successfully identified the site of bleeding and can be regarded an effective tool for detecting active bleeding in an emergency.
Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University School of Medicine, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan.
Takaaki
T
Sugihara
Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University School of Medicine, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan. masakoda@grape.med.tottori-u.ac.jp.
Masahiko
M
Koda
Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University School of Medicine, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan.
Shiho
S
Tokunaga
Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University School of Medicine, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan.
Tomomitsu
T
Matono
Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University School of Medicine, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan.
Takakazu
T
Nagahara
Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University School of Medicine, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan.
Masaru
M
Ueki
Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University School of Medicine, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan.
Yoshikazu
Y
Murawaki
Division of Radiology, Department of Pathophysiological and Therapeutic Science, Tottori University School of Medicine, 36-1 Nishimachi, Yonago, 683-8504, Japan.
Toshio
T
Kaminou
Contrast media; Hemothorax; Sonazoid; Ultrasonography