Halliday Megan, Ingersoll Jared, Alex John
Department of Emergency Medicine, Naval Medical Center Portsmouth, Portsmouth, VA, USA.
Department of Emergency Medicine, Naval Medical Center San Diego, San Diego, CA, USA.
Mil Med. 2020 Dec 30;185(11-12):e2918-e2200. doi: 10.1093/milmed/usaa239.
We discuss a 23-year-old active duty male who presented to the emergency department with left shoulder pain after deadlifting heavy weights the day prior. His physical examination revealed a nontender and otherwise unremarkable left shoulder with full range of motion and mild tenderness to palpation in the left upper quadrant of the abdomen. A bedside focused assessment with sonography for trauma (FAST) examination showed free fluid in the abdomen and a computed tomography scan showed a splenic laceration and splenomegaly. He later tested positive for infectious mononucleosis. This is the first case report of atraumatic splenic laceration after heavy weight lifting. This case illustrates the importance of a broad differential and high index of suspicion in the patient with undifferentiated abdominal pain in order to diagnose a potentially fatal disease.
我们讨论一名23岁的现役男性，他在前一天进行重物硬拉后因左肩疼痛前往急诊科就诊。他的体格检查显示左肩无压痛且无其他异常，活动范围正常，左上腹触诊有轻度压痛。床边创伤超声重点评估（FAST）检查显示腹腔内有游离液体，计算机断层扫描显示脾裂伤和脾肿大。他后来传染性单核细胞增多症检测呈阳性。这是首例关于重物举重后非创伤性脾裂伤的病例报告。该病例说明了对于未分化腹痛患者进行广泛鉴别诊断和高度怀疑指数的重要性，以便诊断一种潜在的致命疾病。
