Hemoperitoneum and Hemothorax from ruptured spleen - Perihepatic Window 30's female. No PMH/Not pregnant. Low BP/tachy presents with syncope. Fell last week. Patient states tripped over dog and hit left side against concrete wall. Mild pain for 5 days but worsened over 24 hours. Now dizzy. Saw "stars" before passing out. Answer: Has ruptured spleen. Note grossly disorganized spleen on Perisplenic window. Has large volume hemoperitoneum in perihepatic and pelvic windows. Outlines uterus on pelvic window. Additionally, note has hemothorax also. Key Point: Significant trauma can present on a delayed basis. Don't ignore because it happened one week ago. Rebleeding in abdominal trauma is common and a real concern. Patients will come in on delayed basis with significant trauma. FAST exam still important in these pts. Labeled Schematic: https://twitter.com/RJonesSonoEM/st Dr. Robert Jones @RJonesSonoEM #Hemoperitoneum #Hemothorax #clinical #ultrasound #pocus #abdominal #trauma #perihepatic
