[The erroneous diagnosis of posttraumatic splenic rupture and cardiorespiratory arrest following laparotomy in a subject occupationally exposed to low environmental temperatures]. / Erronea diagnosi di rottura post-traumatica di milza e arresto cardiorespiratorio successivo a laparotomia in soggetto professionalmente esposto a basse temperature ambientali.

ABSTRACT

We describe the case of a worker professionally exposed to low environmental temperatures who presented anaemia with abdominal pain in apparent succession to a thoraco-abdominal trauma following a car accident. A laparotomy, carried out because of suspected post-traumatic spleen rupture, was complicated by a transitory cardiorespiratory arrest. Subsequently, the patient resulted to be suffering from acute cold agglutinin disease secondary to Mycoplasma pneumoniae infection and from a precedently undiagnosed hypertrophic cardiomyopathy. The temporary removal of the patient from his job contributed to the favourable evolution of the haemolytic disease. Together with the case description, we provide an explanation of the various manifestations observed.