A Case of the Erroneous Diagnosis of Liver Injury in a Child with a Focal Spared Area

Shuichi Takano, Takehito Oshio, Hiroki Ishibashi, Hirotaka Nakamizo
Department of Pediatric Surgery, National Kagawa Children's Hospital

Abstract
Although a focal spared area in the liver is well known as a CT finding in hepatic steatosis, it has rarely been reported in children as yet. We experienced a case who had been erroneously suspected of liver injury. It is necessary to be aware that the focal spared area is also found in childhood.
　　The case was an 11-year-old boy transferred to our institute because of abdominal bruising with abnormal CT findings in the liver. On admission, his general condition was good, but he was markedly obese. Laboratory data were within normal limits except for a mild increase in the levels of serum transaminases. The CT findings showed low density in almost all the parenchyma of the liver. Only the Segment IV revealed a high-density portion, which had been suspected at another hospital to be due to a liver injury. We diagnosed the findings as fatty liver with a focal spared area, and considered the abnormal levels of serum transaminases to be a result of this.

Keywords：Fatty Liver, Liver Injury, Computerized Tomography, Focal Spared Area