[Rupture of a splenic aneurism in an emergency situation].
We report on a 36 year old patient who collapsed at home and was resuscitated by prehospital medical emergency services. He presented on scene unconscious with severe ST-elevations on the ECG and hardly palpable pulses. His previous medical history included only idiopathic hypertension and his professional background as manager of a company was associated with high stress levels. The prehospital diagnosis was myocardial infarction with cardiogenic shock. A hypovolemic shock was excluded from the differential diagnosis because of the age of the patient, lack of a precipitating trauma and inconsistent symptoms. The patient died after terminating prolonged resuscitation. A post mortem showed as cause of death the rupture of a splenic artery aneurysm. We emphasize that a cardiovascular collapse in a young patient without specific history or trauma still can be caused by hypovolemic shock due to intra-abdominal or -thorac bleeding.
Gerling
V
V
Department of Anesthesia, Greenlane Hospital, Auckland, Neuseeland. wuelkere@yahoo.co.nz
Römer
J
J
Eichler
F A
FA
D000328:Adult; D017542:Aneurysm, Ruptured / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004630:Emergencies; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D012151:Resuscitation; D013154:Spleen / Q000098:blood supply*; D013158:Splenic Diseases / Q000175:diagnosis*