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Singap. med. j ; Singap. med. j;: e230-2, 2013.
Article de Anglais | WPRIM | ID: wpr-337833

RÉSUMÉ

A 23-year-old man presented with abdominal pain after suffering blunt trauma caused by a seatbelt injury. His low platelet count of 137 × 10(9)/L was initially attributed to trauma and his underlying hypersplenism due to glucose-6-phosphate dehydrogenase (G6PD) deficiency. Despite conservative management, his platelet count remained persistently reduced even after his haemoglobin and clotting abnormalities were stabilised. After a week, follow-up imaging revealed an incidental finding of a pseudoaneurysm (measuring 9 mm × 8 mm × 10 mm) adjacent to a splenic laceration. The pseudoaneurysm was successfully closed via transcatheter glue embolisation; 20% of the spleen was also embolised. A week later, the platelet count normalised, and the patient was subsequently discharged. This case highlights the pitfalls in the detection of a delayed occurrence of splenic artery pseudoaneurysm after blunt injury via routine delayed phase computed tomography. While splenomegaly in G6PD may be a predisposing factor for injury, a low platelet count should arouse suspicion of internal haemorrhage rather than hypersplenism.


Sujet(s)
Humains , Mâle , Jeune adulte , Douleur abdominale , Diagnostic , Accidents de la route , Faux anévrisme , Imagerie diagnostique , Thérapeutique , Embolisation thérapeutique , Méthodes , Études de suivi , Déficit en glucose-6-phosphate-déshydrogénase , Diagnostic , Score de gravité des lésions traumatiques , Maladies rares , Appréciation des risques , Ceintures de sécurité , Artère splénique , Plaies et blessures , Tomodensitométrie , Méthodes , Résultat thérapeutique , Plaies non pénétrantes , Diagnostic
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