Interesting Case Presentation

28 June 2012

• Echo TTA after a rollover MVC @ 70mph, unrestrained

• Pt was initially evaluated at an OSHx and transferred to MCV

• He was found to have a small left pneumothorax on CXR at OSHx prior to transfer

• PMH: MI, HTN• PSH: None• Meds: HCTZ,

Metoprolol• ALL: NKDA

• 157/100 120 26• 92% on 3L NC• Chest- CTA B,

extensive sub-q air on left chest and left neck

• C-spine, t-spine, l-spine tenderness

• Pt was extubated on POD#1, and received vaccinations

• Was started on a diet POD#6

• Currently ambulating with PT and tolerating a diet

Splenic Injury

• Often heralded by left sided rib fractures• Splenectomized patients are at risk for OPSI• Most recent literature supports non-operative

management for patients who are hemodynamically stable with lower grade injuries

• Operative splenectomy is indicated for hemodynamic instability and unsalvageable injury (Grade IV or V) injury

Splenic Injury