Intended for healthcare professionals

Endgames Spot Diagnosis

Acute hepatitis in a teenager

BMJ 2016; 354 doi: (Published 17 August 2016) Cite this as: BMJ 2016;354:i3997
  1. Sarah Helen Hancox, foundation year two doctor1,
  2. David C Howlett, consultant radiologist1
  1. 1East Sussex Healthcare Trust, Eastbourne District General Hospital, Eastbourne, Sussex, UK
  1. Correspondence to: sarahhancox{at}

A 19 year old woman presented to the emergency department with worsening pain and distension of the right upper quadrant. She was jaundiced and had ascites. A contrast enhanced portal venous phase computed tomogram of the liver at the level of the caudate lobe was requested. What does this show? (Fig 1)

Fig 1


The computed tomogram shows hepatomegaly with heterogeneous enhancement of the liver and sparing of the caudate …

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