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Short answer question case series: abdominal swelling, bruising and pain after fall
  1. Preeti Dalawari1,
  2. Sayanika Kaur1,
  3. John Vandover2,
  4. Jason Schlautman3,
  5. Timothy Jang4
  1. 1Division of Emergency Medicine, Saint Louis University School of Medicine, St. Louis, Missouri, USA
  2. 2Department of Emergency Medicine, Sparta Community Hospital, Medical Director, Sparta, Illinois, USA
  3. 3Department of Emergency Medicine, Saint Anthony's Medical Center, St. Louis, Missouri, USA
  4. 4Department of Emergency Medicine, David Geffen School of Medicine at UCLA, Harbor-UCLA Medical Center, Torrance, California, USA
  1. Correspondence to Dr Timothy B Jang, Department of Emergency Medicine, David Geffen School of Medicine at UCLA, Harbor-UCLA Medical Center,1000 W Carson Ave, D-9, Torrance, CA 90509, USA;tbj{at}ucla.edu

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A 53-year-old male with a history of coronary artery disease presents to the emergency department (ED) with abdominal pain and bruising after a fall onto his abdomen 2 h ago. He does take low-dose aspirin. Initial vital signs included a blood pressure of 129/67 mm Hg and pulse rate of 73 bpm, with normal respirations and temperature. Abdominal examination revealed ecchymosis and swelling of the right lateral abdomen with tenderness to palpation but normal bowel sounds. Repeat blood pressure was 92/47 mm Hg.

Key Questions

  1. What must you consider in this patient?

  2. What is the appropriate diagnostic plan for this patient?

  3. What is the best treatment option for this patient?

  4. What is the anatomy related to this condition?

  5. What are some signs and symptoms related to this condition?

  6. What are the predisposing factors for this condition?

Answers

  1. Given the patient's abdominal pain, swelling and hypotension in the setting of blunt trauma, the clinician should be concerned about acute blood loss. Injuries to the liver, spleen, or vasculature such as the abdominal aorta …

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