Close Call After a Fall: Understanding Traumatic and Atraumatic Splenic Rupture and Its Life-Threatening Consequences.

Splenic rupture, a critical surgical emergency involving the tearing of the spleen's capsule and the ensuing internal bleeding, primarily results from abdominal trauma or underlying medical conditions affecting the spleen. A 71-year-old male with hypertension and hyperlipidemia suffered a mechanical fall, leading to his presentation in the emergency department. Despite a stable initial condition and discharge, he returned the following day with dizziness and severe anemia. Subsequent diagnostics revealed a ruptured spleen, necessitating immediate surgical intervention. This case emphasizes traumatic and atraumatic causes of splenic rupture, with older adults, anticoagulant users, and viral illnesses accentuating vulnerability. Physical exam findings might be absent, highlighting the importance of considering splenic rupture in cases of unexplained hemodynamic instability. In this instance, a combination of trauma, a possible history of anticoagulation use, and a recent viral illness contributed to the patient's splenic rupture. The case underscores the need to retain a high index of suspicion for splenic rupture even without obvious physical findings, advocating for diligent evaluation of abnormal vital signs.

Cricotracheal separation after gunshot to the neck: report of a survivor with recovery of bilateral vocal fold function.

BACKGROUND: Traumatic tracheal injury via blunt or penetrating mechanism comes with a grave prognosis. Cricotracheal separation is a rare entity among these injuries and even more infrequent by means of penetrating trauma. Resultant airway discontinuity subsequent to these insults causes immense global hypoxia and tends to be uniformly fatal. OBJECTIVE: Our aim was to discuss emergent and surgical management of traumatic airway injury. CASE REPORT: We report the case of a 28-year-old male who sustained a gunshot wound to the neck resulting in laryngeal fracture and cricotracheal separation. We review the initial stabilization of his airway and detail the successive surgical management of his injury in the context of the current available literature, with an emphasis on timely airway stabilization when high suspicion for cricotracheal separation exists based on traumatic mechanism. CONCLUSIONS: Emergent management and stabilization of the airway is critical to survival in the context of trauma involving the neck and airway structures.