Diagnosis of spontaneous splenic rupture with emergency ultrasonography. 1998

M Blaivas, and J Quinn
Section of Emergency Medicine, University of Michigan, Ann Arbor, MI.

Rapid evaluation of the hypotensive patient in the emergency department is essential. The availability of ultrasonography in the ED, performed by emergency physicians and surgeons, has made it easier to evaluate the hypotensive trauma patient. We describe a 44-year-old man transferred to our institution from a community hospital for evaluation of syncope and hypotension with no obvious cause. On arrival the patient began to complain of slight lower abdominal pain. The patient's physical examination revealed minimal abdominal tenderness. A rapid ultrasound examination performed at bedside revealed the presence of intraperitoneal fluid. Examination of the spleen suggested likely rupture. The patient was promptly taken to surgery for splenectomy and discharged home in 4 days.

UI MeSH Term Description Entries
D007022 Hypotension Abnormally low BLOOD PRESSURE that can result in inadequate blood flow to the brain and other vital organs. Common symptom is DIZZINESS but greater negative impacts on the body occur when there is prolonged depravation of oxygen and nutrients. Blood Pressure, Low,Hypotension, Vascular,Low Blood Pressure,Vascular Hypotension
D007244 Infectious Mononucleosis A common, acute infection usually caused by the Epstein-Barr virus (HERPESVIRUS 4, HUMAN). There is an increase in mononuclear white blood cells and other atypical lymphocytes, generalized lymphadenopathy, splenomegaly, and occasionally hepatomegaly with hepatitis. Glandular Fever,Mononucleosis, Infectious,Fever, Glandular
D008297 Male Males
D004630 Emergencies Situations or conditions requiring immediate intervention to avoid serious adverse results. Emergency
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012422 Rupture, Spontaneous Tear or break of an organ, vessel or other soft part of the body, occurring in the absence of external force. Ruptures, Spontaneous,Spontaneous Rupture,Spontaneous Ruptures
D013156 Splenectomy Surgical procedure involving either partial or entire removal of the spleen. Splenectomies
D013161 Splenic Rupture Rupture of the SPLEEN due to trauma or disease. Rupture, Splenic,Ruptures, Splenic,Splenic Ruptures
D013575 Syncope A transient loss of consciousness and postural tone caused by diminished blood flow to the brain (i.e., BRAIN ISCHEMIA). Presyncope refers to the sensation of lightheadedness and loss of strength that precedes a syncopal event or accompanies an incomplete syncope. (From Adams et al., Principles of Neurology, 6th ed, pp367-9) Drop Attack,Fainting,Presyncope,Syncope, Postural,Syncopal Episode,Syncopal Vertigo,Syncope, Cardiogenic,Syncope, Carotid Sinus,Syncope, Convulsive,Syncope, Deglutitional,Syncope, Effort,Syncope, Hyperventilation,Syncope, Micturition,Syncope, Situational,Syncope, Stokes-Adams,Syncope, Tussive,Attack, Drop,Cardiogenic Syncope,Cardiogenic Syncopes,Carotid Sinus Syncope,Carotid Sinus Syncopes,Convulsive Syncope,Convulsive Syncopes,Deglutitional Syncope,Deglutitional Syncopes,Drop Attacks,Effort Syncope,Effort Syncopes,Episode, Syncopal,Hyperventilation Syncope,Hyperventilation Syncopes,Micturition Syncope,Micturition Syncopes,Postural Syncope,Postural Syncopes,Presyncopes,Situational Syncope,Situational Syncopes,Stokes-Adams Syncope,Stokes-Adams Syncopes,Syncopal Episodes,Syncope, Stokes Adams,Syncopes,Syncopes, Cardiogenic,Syncopes, Carotid Sinus,Syncopes, Convulsive,Syncopes, Deglutitional,Syncopes, Effort,Syncopes, Hyperventilation,Syncopes, Micturition,Syncopes, Postural,Syncopes, Situational,Syncopes, Stokes-Adams,Syncopes, Tussive,Tussive Syncope,Tussive Syncopes,Vertigo, Syncopal,Vertigos, Syncopal

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