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[Splenic hemorrhage masquerading as myeloproliferative disease]
N Shafran1, G Gewurtz, I E Priel
1Dept. of Internal Medicine E and Institute of Diagnostic Imaging, Edith Wolfson Medical Center, Holon.
Harefuah
|February 16, 1992
Summary
Minor chest trauma can cause spleen injury, sometimes without immediate symptoms. Diagnosis of splenic hemorrhage was confirmed via ultrasound, leading to conservative management.
Area of Science:
- Trauma Surgery
- Diagnostic Imaging
- Hematology
Background:
- Blunt splenic trauma can present with diverse clinical manifestations, including asymptomatic cases.
- Delayed presentation of splenic injury following trauma is a recognized clinical scenario.
- Differential diagnosis for fever and elevated white blood cell count can be broad, including hematological disorders.
Observation:
- A 59-year-old male presented with fever two weeks post-minor chest trauma.
- Initial investigations were suggestive of a myeloproliferative disorder.
- Abdominal ultrasonography was crucial in identifying the splenic pathology.
Findings:
- The patient was diagnosed with subcapsular and intrasplenic hemorrhage.
- The splenic hemorrhage was a sequela of seemingly minor chest trauma.
- Diagnostic imaging confirmed the presence and extent of the splenic injury.
Implications:
- This case highlights the importance of considering splenic injury in patients with delayed presentations of fever after trauma, even with minor initial injury.
- Abdominal ultrasonography is a valuable tool for diagnosing splenic hemorrhage.
- Conservative management can be successful for certain splenic injuries, avoiding surgical intervention.