Confusion and abdominal symptoms following a rugby tackle

Ioannides, Demetris; Davies, Madeleine; Kluzek, Stefan

Abstract

A 19-year-old man was sent to the emergency department following a pitch-side assessment for suspected concussion, unexplained upper abdominal tenderness and vomiting, following a high-impact tackle during a rugby match. A Focussed Assessment with Sonography for Trauma (FAST) scan performed in the emergency department suggested intra-abdominal free fluid, and subsequent head and abdominal CT imaging showed no intracranial lesion but confirmed a significant haemoperitoneum due to large splenic tear and bleeding. An emergency splenectomy was performed, which confirmed the rupture of an enlarged spleen with blood loss of almost 2 L into the peritoneal cavity. The patient made a full recovery following surgery. A subsequent histological examination revealed granulomatous inflammation characteristic of infectious mononucleosis. This unique case illustrates that physically fit patients with early hypovolaemic shock can present with symptoms mimicking concussion.

Citation

Ioannides, D., Davies, M., & Kluzek, S. (2017). Confusion and abdominal symptoms following a rugby tackle. BMJ Case Reports, 2017, Article bcr-2017-222160. https://doi.org/10.1136/bcr-2017-222160

• Journal Article Type: Article
• Acceptance Date: Apr 13, 2017
• Online Publication Date: Sep 23, 2017
• Publication Date: 2017
• Deposit Date: May 20, 2020
• Journal: BMJ Case Reports
• Electronic ISSN: 1757-790X
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 2017
• Article Number: bcr-2017-222160
• DOI: https://doi.org/10.1136/bcr-2017-222160
• Keywords: General Medicine
• Public URL: https://nottingham-repository.worktribe.com/output/4471166
• Publisher URL: https://casereports.bmj.com/content/2017/bcr-2017-222160