The liver twist: A case of accessory liver lobe torsion presenting after mild trauma.

An accessory liver lobe is a congenital anomaly of hepatic tissue most commonly due to embryonic heteroplasia. Rarely, accessory liver lobes can undergo torsion and present as an acute surgical emergency. Although common in certain animals, there are only a few reported cases of accessory lobe torsion in humans. We report a multi-modality radiographic diagnosis of an acute torsion and subsequent infarct of an accessory liver lobe following minor trauma in a 29-year old male patient.

Use of contrast ultrasound in differentiating thrombosed pseudoaneurysm from sarcoma, prior to surgery.

We describe a case of a 69-year-old male with a right-sided popliteal mass following a motor vehicle accident 15 years ago. The mass was indeterminate via multiple modalities (magnetic resonance imaging, digital subtraction angiography, and vascular ultrasound) with biopsy requested prior to surgical removal to determine the appropriate surgical team - vascular versus sarcoma oncologic surgery. Contrast ultrasound was utilized to determine if biopsy was indicated and if so, to determine the most appropriate target. Contrast ultrasound showed no areas of enhancement, therefore biopsy was not performed and the patient safely proceeded to vascular surgery. Pathology confirmed the mass to be a thrombosed pseudoaneurysm of the popliteal artery. We present the benefits of using contrast ultrasound in the work up and diagnosis of a popliteal neoplasm versus suspected vascular complication.