Sonography is the most useful tool per my own experience. Clinical sign is deceiving and we experienced large subcapsular liver hematoma due to UVL without remarkable clinical sign. We probably will obtain pathological evidence after the patient is dead (too late).

Can Sonography alone diagnose UVC extravasation, confirmatively? What are sonographical markers which confirm and/or point towards UVC extravasation? I ask these questions, because our experience shows, that, in a significant minority of cases, UVC extravasation was diagnosed only retrospectively, by Ultrasound (US) scan. The US scans in these babies, showed only echogenicity or calcifications along the tract of UVC, after removing the UVC. They did not have any other clinical or radiological features.

I am no radiologist but I used to do bedside ultrasound myself when I was still a fellow back to my home country. Yes, it was hard to make the diagnosis unless the baby shows some sign of hypotension or shock. My patient had a subcapsular liver hematoma with almost rupture of the capsule but we were lucky to make the diagnosis quick enough and saved the life. If you are in a place where you have to wait for the "certified tech" to come in then it will be too late. Unfortunately this is a common issue in well-developed conutries and we are not allowed to do ultrasound ourselves.