BUŠKOVÁ, Jana, Monika Justýna POLÁČKOVÁ and Zdeněk PAVLOVSKÝ. Koulování – nezvyklá příčina poranění sleziny (Snowball fight – an unusual cause of spleen injury). Česko-slovenská patologie a Soudní lékařství. Praha: Česká lékařská společnost J.E.Purkyně, 2017, vol. 62, No 1, p. 6-7. ISSN 1210-7875.
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Basic information
Original name Koulování – nezvyklá příčina poranění sleziny
Name (in English) Snowball fight – an unusual cause of spleen injury
Authors BUŠKOVÁ, Jana (203 Czech Republic), Monika Justýna POLÁČKOVÁ (203 Czech Republic, guarantor) and Zdeněk PAVLOVSKÝ (203 Czech Republic, belonging to the institution).
Edition Česko-slovenská patologie a Soudní lékařství, Praha, Česká lékařská společnost J.E.Purkyně, 2017, 1210-7875.
Other information
Original language Czech
Type of outcome Article in a journal
Field of Study 30221 Critical care medicine and Emergency medicine
Country of publisher Czech Republic
Confidentiality degree is not subject to a state or trade secret
RIV identification code RIV/00216224:14110/17:00098770
Organization unit Faculty of Medicine
Keywords (in Czech) tupá poranění; poranění sleziny; sněhová koule; hematom sleziny; splenektomie
Keywords in English blunt injury-trauma of spleen; haematoma of the spleen; snowball; splenectomy
Tags EL OK
Tags Reviewed
Changed by Changed by: Soňa Böhmová, učo 232884. Changed: 19/3/2018 17:58.
Abstract
Prezentovaný případ popisuje, jak z původně nevinného koulování může vzniknout život ohrožující stav. Pacient s progredujícími bolestmi břicha byl přivezen rychlou záchrannou službou. Dle anamnézy neuvádí žádné trauma, jen koulování s manželkou před 5ti dny. Na ultrazvukovém vyšetření a počítačové tomografii byl nález poranění sleziny a volné tekutiny v dutině břišní. Dodatečně bylo zjištěno, že toto tupé poranění nevzniklo po nárazu sněhovou koulí, ale že byl manželkou udeřen kusem ledu o velikosti 40 cm. Urgentně byla provedena splenektomie.
Abstract (in English)
Our case describes an innocuous snowball fight arising into a life-threatening condition. Patient with progressive left-sided abdominal pain was brought by ambulance to the hospital. According to history he was not aware of any trauma, just a snowball fight with his wife 5 days ago. Clinical examination finding was: hint of peritoneal irritation, Kehr's sign and left-subchondriurn palpation pain. The spleen trauma suspicion was high. After clinical examination an ultrasound examination was performed, revealing inhomogeneous structure of the spleen surrounded by hypoechoic collection and free fluid in the pelvic area.The patient added information about the possible trauma - it was not an ordinary snowball, but a piece of ice about 40cm. Computed tomography was subsequently performed, with the findings: spleen laceration, intraparenchymal hematoma, subcapsular hematorna and haemoperitoneum. The patient was urgently transferred to the operating room and splenectomy was performed. The intraoperatively findings corresponded to the imaging methods and the amount of blood and clots in the abdominal cavity was approximately 1000ml. The post-operative condition and rehabilitation was uncomplicated and one week after splenectomy the patient was released from hospital, with no subjective difficulties. This case shows spleen susceptibility to injury, even in trauma which can be considered not so severe at the first sight. It is important to correlate clinical and imaging methods findings and check the patient's condition over a longer period, if necessary.
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