Spontaneous hemorrhage or rupture has been estimated to occur in up to 10% of HCCs . An echogenic rind surrounding the liver has been described as a common finding in this clinical scenario, representing either acute hemoperitoneum or subcapsular hematoma .
Oblique view through the right flank in a patient with upper abdominal pain reveals fluid in the peri-renal space and para-renal space. Note hypoechoic, thickened para-renal fat linear, hypoechoic plane between the pancreas (P) and splenic vein/portal confluence .
ultrasound images of peripancreatic/perirenal fluid in below: