To the Editor.—
When patients are admitted to a hospital with suspicion of splenic hemorrhage, a normal abdominal aortogram is not entirely reliable, and selective splenic arteriography must be undertaken for definitive diagnosis. The following case illustrates this principle.
Report of a Case.—
A 32-year-old woman was admitted to the San Bernardino County General Hospital following an automobile accident, with fractures of the left lower leg and lower ribs, and a pneumothorax on the left side. The blood pressure initially was 84/60 mm Hg, becoming 110/70 mm Hg following infusion of plasma and the insertion of a chest tube. Hematocrit value was 33.3 on admission. Results of physical examination showed left-upper-quadrant tenderness, and abdominal paracentesis returned with a red blood cell count of 130,000/cu mm. The patient's vital signs and abdominal findings remained stable.Abdominal aortography gave normal findings (Fig 1), with particular attention directed to the splenic artery and
Sadler RB, Chinn J. Negative Aortogram Not Reliable for Diagnosis Of Splenic Hemorrhage. JAMA. 1972;221(7):712. doi:10.1001/jama.1972.03200200058019