Simulation Case: Spontaneous Rupture of Splenic Artery Aneurysm, an Uncommon Cause of Abdominal Pain and Hypotension

Simulation Case: Spontaneous Rupture of Splenic Artery Aneurysm, an Uncommon Cause of Abdominal Pain and Hypotension

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Abstract This resource is a simulation case based on an actual patient encounter.It includes actual images from studies as well as actual values of laboratory studies.The goal is to provide residents with an immersive clinical experience that simulates the diagnostic and treatment challenges incorporated in the emergency department care of a patient presenting with abdominal pain and hypotension 100w products in an unusual and uncommon case of splenic artery aneurysm rupture.The primary goal is for the student to quickly assess and resuscitate the patient, utilize diagnostic tools to get to a general diagnosis of surgical abdomen with hemoperitoneum, and make a timely disposition.

The patient in the case is a 63-year-old male who presents to a large urban hospital emergency department complaining of abdominal pain that he attributes to eating bad leftover pizza.He has some mild hypotension but is alert and oriented.He was hp pavilion 15-eg1053cl fluid responsive initially but became hypotensive again.Clinically, he does not appear that ill and seems quite stable, but there is no adequate explanation for the hypotension.

Further investigations include abdominal ultrasound and CT with IV contrast, which result in a diagnosis of splenic artery aneurysm and likely rupture with free fluid/blood in the abdomen.The patient is admitted to surgery and undergoes exploratory laparotomy, resulting in splenectomy and splenic artery ligation.This case has been successfully implemented multiple times with emergency medicine residents using a high-fidelity simulation mannequin.It has been added to the simulation case library for the Center for Immersive Medical Education and Research at the Wright State University Department of Emergency Medicine Residency and will continue to be used for educational purposes in teaching the workup for undifferentiated abdominal pain, shock, and medical resuscitation.