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RUQ US
Vgague Abdominal Pain

Findings and DDx?

Answers:

Hepatitis / “Starry Sky” Appearance

• The “starry sky” appearance of the liver results from increased echogenicity of the portal triads
• DDx: hepatitis, portal air, leukemic infiltrate, diffuse lymphoma, toxic shock syndrome
• Note that hepatitis usually results in no abnormality on US; even when present the “starry sky” appearance is often subtle