NoM Spleen Returns

[Ronald Simon]

Coil, would have done it the first time
ron simon

Bjorn, Pret wrote:

>Adult female MVC.  Left rib fx's 10-12, known splenic inj, read as Grade
>I in spite of contrast blush (not intended as the thrust of this
>thread).  
>
>The patient was admitted for two nights, stable throughout, and
>discharged with her cooperation and enthusiasm.  She was prescribed
>house arrest for a week, drastically limited activity, and an office
>visit to follow.
>
>As fate would have it, on post-injury day 6 she suffered a sudden sharp
>LUQ pain with what sounds like a brief vagal response.  She reported
>immediately to her local ED, where another CT shows both a persistent
>blush plus intraperitoneal hemorrhage (second image).  
>
>At the local hospital, vitals were stable (she was in fact hypertensive
>consistent with her medical history) and her labs were unremarkable (H&H
>12 and 35, roughly identical to previous discharge numbers).  She was
>admitted to the local hospital for observation, but her counts slipped
>overnight (10 & 27), and so she was transferred back to us.  She arrives
>stable and without any major complaints.  Even a little hungry.
>
>Interested in what others would plan for her.  Observe?  Coil?  Both?
>Other?
>
>Pret Bjorn, RN
>
>
> <<FirstImage.jpg>>  <<SecondImage.jpg>> 
>  
>
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-- 
Ronald Simon, MD
Dir of Trauma/SICU
Jacobi Medical Center, Rm 1213
Bronx, NY 10461
718 918 5598 phone
718 918 5593 fax