PMID: 21774298Jul 22, 2011Paper

Fatally idiopathic spontaneous hemoperitoneum in a patient with cervical spine injury: a case report and review of the literature

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
Chayanin AngthongCholavech Chavasiri

Abstract

Idiopathic spontaneous hemoperitoneum has never been reported in patients with associated orthopedic injury. The present report aimed to demonstrate a case of this life-threatening condition concomitant with cervical spine injury. A 50-year-old male was an illegal immigrant and transferred to the emergency department with the conditions of the bilateral facet subluxation of C5-6 spine, including incomplete cord lesion (American-Spinal-lnjury-Association: grade-C) and without associated injury, caused by falling from a 3-meters-scaffold He underwent anterior cervical discectomy, fusion with iliac bone graft, and plating of C5-6 level at 20-hours after injury His overall conditions recovered gradually with the same neurological deficit as pre-operative status. On postoperative day 15, he developed acute hemodynamic instability and cardiac arrest in an hour without preceding signs. Autopsy showed free intra-peritoneal blood 1000 ml and fresh blood in gastric lumen-small bowels 500 ml without definitive source of bleeding. The patient in this present report had no complaint of preceding abdominal symptoms in both pre-and-postoperative periods. His visceral sensibility might be lost due to incomplete cord lesion. At this point, he m...Continue Reading

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