A case of severe abdominal right upper quadrant pain in a patient on ASS and Clopidogrel

Purpose: We describe the case of a 73 year old patient with a large subhepatic mass and two hepatic lesions found on external US. The patient had no known liver disease and was on dual platelet inhibition for a DES that had been implanted 4 months prior. Material and methods: We performed US, CEUS, MRI and liver histology Results: US raised suspicion of a HCC in SII (24 ml) and a second HCC in SV (16 ml) with a big subhepatic hematoma after spontaneous bleeding. (When asked, the patient reported severe RUQ pain 2 weeks before.) There were no obvious signs of cirrhosis. CEUS of the lesion in SII was suggestive of…