DOI: 10.36347/sjmcr.2016.v04i04.017

Pages: 239-241

A 62-year-old male wearing a seatbelt drove and stopped his car around a curve. Another car, driving at a right angle to the curve at a speed of 20-30 km, directly collided into the right side (driver’s side) of the car. Upon arrival, he showed tenderness on the right lower side of the thorax. A traumatic pan-scan revealed right rib fractures from the 9th to 12th rib. After admission, the level of hemoglobin gradually decreased to 8.6 g/dl until the 3rd hospital day. CT on the same day for detection of the bleeding source demonstrated a moderate amount of fluid collection with low–isodensity around the spleen. Emergent splenic angiography showed splenic injury. After partial embolization and transfusion, the patient’s anemia did not worsen. Splenic injury is the most common intra-abdominal injury associated with left lower rib fractures. However, the present case demonstrated that impact to the right side of body can cause internal organ injury of the opposite side, such as splenic injury. Accordingly, physicians should therefore be aware that internal abdominal organ injury on the opposite side may occur through indirect impact delivered during interaction with an external force.