UNUSUAL PRESENTATION OF SPLENIC INJURY AFTER BLUNT ABDOMINAL TRAUMA

Background: The spleen is the most commonly injured viscous in blunt abdominal trauma. Abdominal pain with left upper quadrant tenderness or signs of peritonitis in a patient with history of trauma is the most common presentation of this condition. Objective: To describe an unusual presentation of splenic rupture in a patient with history of motor vehicle crash and blunt abdominal trauma. Case Report: A young man was brought to the Emergency Department with a history of being in a motor vehicle crash 10 hours earlier. He experienced gradually worsening difficulty breathing while sitting or lying down for the previous 4 hours, although he was asymptomatic in the upright position. He was transported to the hospital. The patient was found to have left upper quadrant abdominal tenderness on examination and free fluid in the pelvis on the focused abdominal sonography for trauma. A grade III splenic injury with hemoperitoneum was diagnosed on computed tomography scan and the patient was treated with splenectomy. Conclusion: We report an unusual presentation of a splenic injury in a young man who had symptoms only in the supine position.