title: Splenic injury sustained during body hardening drills and the utility of ultrasound in a prehospital combat medical environment.
abstract: This report describes a case of intra-abdominal hemorrhage from body hardening drills in a U.S. soldier during Operation Iraqi Freedom. In body hardening, participants allow themselves to be repeatedly punched and kicked in an effort to impart physical resilience. Portable sonography was used to diagnose hemoperitoneum and to guide the decision for urgent surgical evacuation, ultimately resulting in splenectomy. The case illustrates the risks of body hardening, the medical challenges unique to a prehospital combat environment, and the utility of ultrasound in this setting.
authors.affiliation: Forward Operating Base Rustamiyah, C Company 94th BSB, APO-AE 09390, USA.
authors.forename: John J
authors.initials: JJ
authors.lastname: Everett
authors.forename: Brooks
authors.initials: B
authors.lastname: Laselle
authors.forename: John
authors.initials: J
authors.lastname: Kendall
mesh_terms: D000007:Abdominal Injuries / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D003937:Diagnosis, Differential; D004632:Emergency Medical Services / Q000379:methods*; D006465:Hemoperitoneum / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D013154:Spleen / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D013156:Splenectomy / Q000379:methods; D013997:Time Factors; D014463:Ultrasonography / Q000706:statistics & numerical data*; D055815:Young Adult