When the going gets rough : a sequela of splenic trauma

Abstract

A 45-year-old man presented with left-sided flank pain 2 days after a rough game of football. On examination, extensive bruising was evident over his left chest wall. His vital parameters were stable with a blood pressure reading of 129/85 mm Hg and a slight tachycardia of 105 bpm. He was exquisitely tender over the left seventh to nineth ribs. Rib fractures were confirmed on plain radiography and an ultrasound of the abdomen was performed to exclude any underlying visceral injury. An abdominal ultrasound demonstrated free intra-abdominal fluid. A 1.5 cm round, hypoechoic lesion was present within the spleen. On colour Doppler examination bidirectional internal flow was observed with the typical ‘Yin-Yang’ sign consistent with a pseudoaneurysm.