Published in:
01-01-2017 | Classics in Abdominal Imaging
Turtleback liver
Published in: Abdominal Radiology | Issue 1/2017
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Turtleback represents a shiny, highly complicated protective shield in turtles and tortoises (Fig. 1). This protective shield has a very distinctive pattern, which can be useful in identification of the species. “Turtleback liver” is the classical appearance described in reference to chronic Schistosoma japonicum infection of the liver [1]. The liver margins are irregular and nodular with capsular calcification (Fig. 2A) [1]. Fibrotic septa are also noted within the liver, which in advanced cases can result in a coarse polygonal network pattern, resembling a turtleback [2].
Fig. 1
Photograph of a turtle
Fig. 2
A, B A 42-year-old man was admitted for abdominal distension and deranged liver function tests. Contrast-enhanced CT axial image A shows marked nodularity of liver margins with areas of calcification, mainly along the capsule. Prominent linear hypodensities are oriented perpendicular to the liver capsule (B, C). Overall appearance resembles a “turtleback.” Changes of portal hypertension are also seen with enlarged spleen and peri-splenic varices
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