International Journal of Emergency Medicine (Nov 2022)

An unusual case of a traumatic splenic rupture masquerading as myocardial ischemia: a case report

  • B. M. Munasinghe,
  • U. P. M. Fernando,
  • Thileep Kumar,
  • Chamika Huruggamuwa,
  • K. A. R. L. Kuruppu,
  • G. G. C. Hewawasam

DOI
https://doi.org/10.1186/s12245-022-00469-7
Journal volume & issue
Vol. 15, no. 1
pp. 1 – 5

Abstract

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Abstract Background The spleen is one of the most frequently injured abdominal organs during trauma, which can result in intraperitoneal bleeding of life-threatening magnitude. Although splenic injury secondary to trivial trauma comprises a minor fraction of abdominal injuries, undiagnosed or delayed diagnosis may result in a complicated clinical course. Case presentation One such event is presented here, wherein a late diagnosis of an advanced grade splenic injury following a trivial trauma initially presented in disguise as acute myocardial ischaemia in a previously healthy South Asian woman in her late 30s. Emergency laparotomy and splenectomy were performed with simultaneous massive transfusion for a 3.5-L blood loss. She subsequently had an uncomplicated clinical course with regular surgical follow-up. Conclusion Splenic injuries might present with ambiguous symptoms such as atypical chest pain and shoulder pain, necessitating attending clinicians to have a high degree of suspicion, especially in busy units such as the emergency department (ED).

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