AN UNUSUAL CASE OF A TRAUMATIC SPLENIC INJURY MISD amal4148@hotmail.com

 

AN UNUSUAL CASE OF A TRAUMATIC SPLENIC INJURY MISD

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Saudi Arabia

Poster with Discussion

The spleen is one of the most frequently injured abdominal organs during trauma, which can result in intraperitoneal bleeding of life-threatening magnitude. undiagnosed or delayed diagnosis may result in a complicated clinical course.

Case presentation

A 30 year old healthy lady Presented to ER with complain of generalized abdominal pain after history of syncopal altack at home. She mentioned recent practice on horse riding 1 month. But no significant history of direct trauma. Up on examination she was hypotensive, tachycardlac. Abdomen examination showed generaltzed tenderness. After resuscitation she became borderline hypotensive. Investigations showed low HB level 6, CT scan abdomen with contrast was Inconclusive (Evidence of large hematoma seen in the pelvis in addition to significant free fluld seen in the rest of the abdomen and pelvis, suspicion of left ovartan rupture cys). Decision made to take the patient for exploration, lower mid-line Incision made, about 2 L of blood and clots evacuated, both ovarles Inspected all were normal, bleeding not stopped, Inclsion was extended to upper mid-line, packing done 4 quadrants, examination of the Intrapertoneal organ showed no signs of bleeding beside fresh blood coming from behind the spleen, bleeding sopped after clamping the spienic pedicle, decision was made to perform splenectomy as patient's condition was critical. After splenectomy patent became stable,

Recent guidelines recommend dual arterialiportal venous phase imaging for evaluation of a vascular Injury of the liver, spleen, and kidney