Here’s an interesting one for you to solve!
A 20ish year old male was involved in a motor vehicle crash, sustaining a Grade IV spleen injury. He fails nonoperative management early in his hospital course, undergoing a splenectomy 6 hours later.
He has an uneventful recovery and is ready for discharge after 5 days. His platelet count has plateaued at 600K. He presents to your ED 2 weeks later complaining of abdominal pain. On exam, he is diffusely but mildly tender. His subjective complaints appear to be a bit out of proportion to his exam.
Here is one slice from his CT scan. I’ve put a nice fat arrow on it to help out. But it won’t.
- What does the scan show?
- Why is it there?
- What other key piece of information do you want to know?
- Any other studies?
- Then what?
Some hints tomorrow! Tweet your answers or leave comments below! Let’s see if anyone can figure this one out!