Wandering spleen

Wandering spleen Young-Shin Cho, Ki-Won Yu, Ho-Jung Kim, Yong-Seung Kim, Pyeong-Moon Jang, Jung-Won Lee, Hoon Lim Emergency Medicine Soon Chun Hyang Univ. Bucheon Hospital Case presentation Patient F/31, housekeeper Chief compliant : LUQ pain pain character : dull, vague, consistent with burning onset : recent - 2days ago mode : insidiously Present illness 평소 건강하게 지내던 31세 여자 환 자가 내원 2일전부터 발생한 소화불 량 및 좌상복부 통증을 주소로 본원 응급의료 센터 내원함 Past history DM(-) HTN (-) Hepatitis (-) Tb(-) Recent trauma history(-) URI(+) : 1 month ago, treated with drugs until 1 week before. Review of system General weakness(-) Fever(-) Dyspepsia(+) Dysphagia(-) Nausea(+) Vomiting(+) Diarrhea(-) Constipation(-) Hematochezia(-) Melena (-) Abdominal pain(+): LUQ pain Physical examination Vital sign BP:130/90 mmHg BT : 36.7℃ PR : 76/회 RR : 20/회 Chest Symmetric chest expansion Clear breathing sound without wheezing or rale Regular heart beat without murmur Abdomen Soft/ flat LUQ tenderness(+) : mild Rebound tenderness(-) Decreased bowel sound Back & Extremity Pretibial pitting edema(-/-) Lt CVA tenderness(+) Laboratory finding ED progress note (05.03.09) 08:00 - 환자 내원 Radiologic finding 08:20 – LAB, X-ray, fluid start 09:20 – symptom 호전 없음 antispasmodics, antiemetics start 11:25 – symptom 호전 되어 귀가함 21:00 - 재내원 21:20 - Amylase, lipase, X-ray F/U, pain control (tramadol) 23:30 - fluid connected, pain control (meperidine) 02:00 - abdomen USG at ED GI part admission 결정함