Sentinel Clot

An adherent blood clot or prominent blood vessel, seen by upper GI endoscopy in 23 of peptic ulcers that have previously bled, occurring when a lateral defect in the arterial wall protrudes as a plug of fibrin above the ulcer base
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Noncontrast CT revealed left retroperitoneal hematoma contiguous with the aorta, IVC, and retroaortic sentinel clot.
The large left retroperitoneal hematoma was contiguous with the IVC/lumbar vein and was highlighted by the sentinel clot.
The value of the sentinel clot sign providing reliable evidence indicating the origin of the bleed (by virtue of the higher density clot in that area, versus the lesser density elsewhere) and haematocrit-sign of anticoagulation, were convincingly illustrated by case material.
We report a case of retropharyngeal hematoma in which an accurate diagnosis was obtained on CT by virtue of the detection of a sentinel clot adjacent to the area of the parathyroid and thyroid glands.
A focal area of higher density within this space, which was believed to represent a sentinel clot, had displaced the thyroid gland anteriorly and the carotid space laterally, and it had compressed the trachea, pharynx, and esophagus.
Detection of a sentinel clot reliably indicates the presence of an injury to an adjacent organ.
It may also detect a sentinel clot and thereby direct the radiologist to the source of the hemorrhage.