PMC4936497_01
Abdominal CT scan. (A) Coronal plane (B) Sagital Plane. Shows splenic rupture associated with a subcapsular hematoma and the presence of a linear hyperdense foreign body in the spleen, of 3.0 cm, close to the splenic flexure of the colon.
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After primary ER medical treatment he was evaluated by general surgery and an abdominal and chest contrasted CT scan was ordered, which reported a splenic rupture associated with the presence of a linear FB of 3.0 cm, focal inflammatory changes and intrasplenic collection (Fig. 1).
Laparotomy and splenectomy images. (A) Surgical field during splenectomy and surgical drainage of hemoperitoneum that shows the presence of a large fishbone (Black arrow); (B) Fishbone recovered during surgery.
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Written and informed consent was obtained and, an exploratory laparotomy was therefore performed to resolve his acute abdominal pain due to the high risk of peritonitis (Fig. 2).
Gross examination of specimens obtained during surgery. (A) An Enlarged spleen (13.5 x 10 x 5 cm) that weighted 342.1 g, with a subcapsular hematoma of 9 x 7 cm and a traumatic rupture of 80% of the posterior aspect; (B) Sharp large fishbone of 3 x 0.1 x 0.1 cm.
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Splenectomy was performed, the hemoperitoneum was drained and the fishbone was recovered (Fig. 3).