November 12, 2014
Notes: Sarr, Michael G
Banks, Peter A
Bollen, Thomas L
Gooszen, Hein G
Johnson, Colin D
Tsiotos, Gregory G
Vege, Santhi Swaroop
Consensus Development Conference
Surg Clin North Am. 2013 Jun;93(3):549-62. doi: 10.1016/j.suc.2013.02.012. Epub 2013 Mar 27.
Author Address: Department of Surgery, Mayo Clinic GU 10-01, 200 First Street Southwest, Rochester, MN 55905, USA. email@example.com
Reference Type: Journal Article
Record Number: 5224Author: Sawrey, M. and Hughes, R. G.
Title: An interesting cause of collapse in a patient with chronic pancreatitis
Journal: BMJ Case Rep
Short Title: An interesting cause of collapse in a patient with chronic pancreatitis
Alternate Journal: BMJ case reports
ISSN: 1757-790X (Electronic)
Accession Number: 23697449
Abstract: A 55-year-old man attended the emergency department following an episode of collapse. He was known to have chronic pancreatitis and a pancreatic pseudocyst. He had recently been recumbent due to chronic abdominal pain. On arrival he was unwell. Baseline observations revealed an oxygen saturation of 87% on room air, pulse 115 bpm and blood pressure 86/57 mm Hg. Physical examination was unremarkable except for mild abdominal tenderness. He was started on high-flow oxygen, intravenous fluid and broad-spectrum antibiotics. A chest x-ray was unremarkable. Massive pulmonary embolus was considered a likely diagnosis. The patient underwent an urgent CT pulmonary angiogram (CTPA). As this was undertaken as an urgent investigation straight from the resuscitation area a d-dimer test was not performed. The CTPA showed no evidence of pulmonary embolism but demonstrated a subdiaphragmatic collection. An arterial phase abdominal CT scan was thus performed, which confirmed a large subcapsular splenic haematoma and splenic vein thrombosis. The patient was resuscitated with blood products and transferred for splenic artery embolisation.