case_images: PMC4225153_01
case_images: Abdominal ultrasonography mode 2 D showed a effusion at the Morrison's pouch with low abundance and contusion of the lower edge of the liver (red arrow)V
case_images: PAMJ-17-176-g001.jpg
case_images: PMC4225153_01_PAMJ-17-176-g001.jpg
case_images: F0001
case_images: Referring us to a 60 year old male patient, without pathological antecedents, accident victim of the highway with the point of abdominal impact, admitted to the ICU for monitoring, review the admission showed a well oriented in space and time, personality anxious, the palpebral conjunctivae were not pale, stable blood pressure with 120/70 mm hg, painful on palpation of the abdomen in the right upper quadrant, the examination of the chest is normal without pain, cardiac examination is completely normal except for a slight bradycardia to 54 beat / min. ultrasound abdominal (Figure 1) showed a perihepatic effusion of low abundance with contusion of the lower edge of the liver, echocardiography (Figure 2) bedside was systematically whatever reason in any patient admitted to the ICU, showed in our patient: a bollonisation with akinesia ( lack of mobility and thickening myocardial) apical with hyper kinesis basal, the fraction ejection estimated at 45%, no valvulopathy associated, dry pericardium, the ascending and abdominal aorta without abnormality, size and respiratory compliance of the inferior vena cava were normal.
case_images: Echocardiogram on admission demonstrated apical akinesis with hyper kinesis basal and ballooning of the left ventricle apex (blue arc); A End-systolic phase, B End-diastolic phase.(LA: left atrium, LV: left ventricle, RV: right ventricle, RA: right atrium)
case_images: PAMJ-17-176-g002.jpg
case_images: PMC4225153_01_PAMJ-17-176-g002.jpg
case_images: F0002
case_images: Referring us to a 60 year old male patient, without pathological antecedents, accident victim of the highway with the point of abdominal impact, admitted to the ICU for monitoring, review the admission showed a well oriented in space and time, personality anxious, the palpebral conjunctivae were not pale, stable blood pressure with 120/70 mm hg, painful on palpation of the abdomen in the right upper quadrant, the examination of the chest is normal without pain, cardiac examination is completely normal except for a slight bradycardia to 54 beat / min. ultrasound abdominal (Figure 1) showed a perihepatic effusion of low abundance with contusion of the lower edge of the liver, echocardiography (Figure 2) bedside was systematically whatever reason in any patient admitted to the ICU, showed in our patient: a bollonisation with akinesia ( lack of mobility and thickening myocardial) apical with hyper kinesis basal, the fraction ejection estimated at 45%, no valvulopathy associated, dry pericardium, the ascending and abdominal aorta without abnormality, size and respiratory compliance of the inferior vena cava were normal.
case_images: Electrocardiogram demonstrated ST segment elevation in lead DIII V2 V3 V4 V5 V 6 and specially -aVR (red ellipse)
case_images: PAMJ-17-176-g003.jpg
case_images: PMC4225153_01_PAMJ-17-176-g003.jpg
case_images: F0003