AI Article Synopsis
- An 89-year-old woman presented to the emergency department with low blood pressure and confusion but showed no signs of trauma or injury.
- Point-of-care ultrasound revealed free fluid in the abdomen and a large mixed echogenicity lesion on her spleen, leading to the discovery of a ruptured hemorrhagic splenic cyst confirmed by CT scan.
- The patient underwent an emergency splenectomy, which revealed the cyst to be a splenic hemangioma, emphasizing the effectiveness of the RUSH protocol for diagnosing undifferentiated hypotension in cases without obvious trauma.
Article Abstract
An 89-year-old female presented to the emergency department (ED) with hypotension and altered mental status. The patient had no external signs of trauma or hemorrhage and no abdominal tenderness on examination. The patient remained hypotensive after initial fluid resuscitation, and laboratory testing revealed a significant anemia. Point-of-care ultrasound (POCUS) was used to perform a rapid ultrasound in shock (RUSH) exam in an attempt to uncover the etiology of undifferentiated hypotension. The exam displayed free fluid in the right upper quadrant and the left upper quadrant exam demonstrated a large splenic lesion with mixed echogenicity. Subsequent computed tomography (CT) of the abdomen and pelvis with intravenous contrast suggested a ruptured hemorrhagic splenic cyst, and the patient underwent an emergent splenectomy for hemorrhage control. Operative pathologic examination revealed the cystic lesion to be a splenic hemangioma. This case report highlights the utility of the Rapid Ultrasound for Shock and Hypotension (RUSH) protocol when evaluating patients with undifferentiated nontraumatic shock, and a rare cause of spontaneous intra-abdominal hemorrhage.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11293879 | PMC |
| http://dx.doi.org/10.7759/cureus.63698 | DOI Listing |
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