ULTRASONOGRAPHY - INDISPENSIBLE SHIELD FACING MALPRAXIS.

We present the case of a 38-year-old patient who presented in the emergency department for asthenia and fatigue, interscapulo-vertebral pain, with about 2 days of onset. As a result of the investigations carried out in emergency (clinical examination, abdominal ultrasound - peritoneal collection; cardiological examination), a normochrome, normocytic anemia of uncertain etiology and an ascitic collection of undetermined etiology were found. We were called to admit the patient on the gastroenterology department in order to continue diagnostic work-up. We restarted the anamnesis, which revealed a minor lumbar trauma, and we repetead the ultrasound examination, which revealed an hypoecogenic, vague, irregular contour of the spleen, in addition to the peritoneal collection. Diagnostic paracentesis was performed, with the appearance of fresh blood, and then the diagnostic balance continued with abdominal CT with contrast substance. The diagnosis of post-traumatic splenic rupture, hemoperitoneum, normochrome, normocytic anemia was established, and the therapeutic conduct consisted of total splenectomy. Abdominal ultrasound examination was essential in establishing the diagnosis, being the one that drew attention to the background splenic pathology, which subsequently dictated the therapeutic conduct, without which the patient's prognosis would have remained reserved. This case illustrates the importance of controlling the ultrasound method so that the patient benefits from the most correct therapeutic approach and the physician is able to go through a wide range of differential diagnoses in order to correctly establish the positive diagnosis. [ABSTRACT FROM AUTHOR]