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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