1. Interesting Case Presentation
28 June 2012

2. Echo TTA after a rollover MVC @ 70mph, unrestrained
Pt was initially evaluated at an OSHx and transferred to MCV
He was found to have a small left pneumothorax on CXR at OSHx prior to transfer

3. PMH: MI, HTN
PSH: None
Meds: HCTZ, Metoprolol
ALL: NKDA
157/
92% on 3L NC
Chest- CTA B, extensive sub-q air on left chest and left neck
C-spine, t-spine, l-spine tenderness

17. Pt was extubated on POD#1, and received vaccinations
Was started on a diet POD#6
Currently ambulating with PT and tolerating a diet

20. Splenic Injury Often heralded by left sided rib fractures
Splenectomized patients are at risk for OPSI
Most recent literature supports non-operative management for patients who are hemodynamically stable with lower grade injuries
Operative splenectomy is indicated for hemodynamic instability and unsalvageable injury (Grade IV or V) injury

21. Splenic Injury