Prognostic value of ultrasound in early arterial complications post liver transplant

Figure 4 A 48-year-old female patient underwent a piggyback liver transplantation procedure due to decompensated cirrhosis resulting from hepatitis B. A: Evaluated 13 d postoperatively, the patient’s clinical history revealed a progressive decline in blood pressure and red blood cell count, accompanied by the accumulation of a significant volume of intraperitoneal fluid. Conventional ultrasound examination demonstrated a substantial accumulation of fluid in the porta hepatis region, characterized by hypoechoic features and the presence of numerous fine, low-level echogenic particles suspended within. Contrast-enhanced ultrasound revealed enhanced contrast agent pooling within the intraperitoneal fluid of the porta hepatis, exhibiting a morphology resembling a mushroom cloud (highlighted by the orange arrow); B: Notably, further tracking of the contrast agent leakage within the porta hepatis area (indicated by the orange arrow) indicated that it originated from the hepatic artery anastomosis site.