[The erroneous diagnosis of posttraumatic splenic rupture and cardiorespiratory arrest following laparotomy in a subject occupationally exposed to low environmental temperatures].
We describe the case of a worker professionally exposed to low environmental temperatures who presented anaemia with abdominal pain in apparent succession to a thoraco-abdominal trauma following a car accident. A laparotomy, carried out because of suspected post-traumatic spleen rupture, was complicated by a transitory cardiorespiratory arrest. Subsequently, the patient resulted to be suffering from acute cold agglutinin disease secondary to Mycoplasma pneumoniae infection and from a precedently undiagnosed hypertrophic cardiomyopathy. The temporary removal of the patient from his job contributed to the favourable evolution of the haemolytic disease. Together with the case description, we provide an explanation of the various manifestations observed.
Cirasino
L
L
Divisione Medica Rizzi, Ospedale Niguarda Ca' Granda, Milano.
Marcotti
A
A
Barosi
G
G
Massaro
F
F
Silvani
A
A
D000063:Accidents, Traffic; D000208:Acute Disease; D000744:Anemia, Hemolytic, Autoimmune / Q000175:diagnosis; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis; D003080:Cold Temperature / Q000009:adverse effects*; D003951:Diagnostic Errors; D006323:Heart Arrest / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007813:Laparotomy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications; D016273:Occupational Exposure / Q000009:adverse effects*; D011019:Pneumonia, Mycoplasma / Q000175:diagnosis; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology; D013161:Splenic Rupture / Q000175:diagnosis*