Dr. Diego Scarpetta, an internist from Colombia in South America, ordered his ultrasound probe from geteagleview.com and shared us with some cases of clinical scans using Eagleview Ultrasound.

A 51-year-old male with a history of hypertension. He was admitted at 21:30 to ER for burns of 18% of the TBS (face, left hemithorax, both arms) after being exposed to a gas cylinder explosion. Nasal hair was partially burned, without burning of the oral mucosa, carbonaceous sputum, or hoarseness. It was performed a CT scan of the abdomen and thorax did not appear to have shock wave injuries (pneumothorax or pneumoperitoneum).

Infusion of intravenous fluids (Baxter, PMH) was started, and vaseline dressings with chlorhexidine were applied. He was admitted to airway surveillance in ICU. He arrived with O2 sat > 96%, stable vital signs, controlled pain, soft and depressible abdomen, preserved diuresis. Normal lab tests.

He remained stable overnight, SatO2 is ok. However, at 06:20 the patient began to complain of abdominal pain and nausea. Additionally, he looked pale, had tachycardia, and with a tendency to hypotension.

07:10 am, 50 mmHg Adrenergic vasopressors were started through a subclavian CVC.

07:20 am, He remained with a soft abdomen but complained of mild pain (3/10), an urgent control of total blood count was requested due to suspected bleeding.

07:30 am, A FAST protocol was performed, finding abundant free fluid in Morrison’s space and rectovesical pouch; no observation was made in the splenorenal recess because he had dressings in that location. The patient was evaluated by a surgeon minutes later, and despite the abdomen wasn’t painful or with peritonitis signs, massive retroperitoneal bleeding was suspected.

09:45 am, a lab call was received to report a decrease in hemoglobin from 12.9 to 8.9 g / dl.

10:00 am, Official report of CT scan: Liver: diffuse fatty infiltration. The gallbladder, bile duct, pancreas, kidneys were ok. Spleen with irregular margins with perisplenic hematoma. No pneumoperitoneum. A moderate amount of fluid with blood density in a left paracolic leak that extends into the pelvis, contacting the external iliac vessels on the left side and the urinary bladder.

10:30 am, the patient was transferred to surgery. Op findings: Drainage of 3000 ml of blood material. Splenic vessel injury was ligated.