@article{ref1,
title="Confusion and abdominal symptoms following a rugby tackle",
journal="BMJ case reports",
year="2017",
author="Ioannides, Demetris and Davies, Madeleine and Kluzek, Stefan",
volume="2017",
number="ePub",
pages="ePub-ePub",
abstract="A 19-year-old man was sent to the emergency department following a pitch-side assessment for suspected concussion, unexplained upper abdominal tenderness and vomiting, following a high-impact tackle during a rugby match. A Focussed Assessment with Sonography for Trauma (FAST) scan performed in the emergency department suggested intra-abdominal free fluid, and subsequent head and abdominal CT imaging showed no intracranial lesion but confirmed a significant haemoperitoneum due to large splenic tear and bleeding. An emergency splenectomy was performed, which confirmed the rupture of an enlarged spleen with blood loss of almost 2 L into the peritoneal cavity. The patient made a full recovery following surgery. A subsequent histological examination revealed granulomatous inflammation characteristic of infectious mononucleosis. This unique case illustrates that physically fit patients with early hypovolaemic shock can present with symptoms mimicking concussion.<br><br>© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.<p /> <p>Language: en</p>",
language="en",
issn="1757-790X",
doi="10.1136/bcr-2017-222160",
url="http://dx.doi.org/10.1136/bcr-2017-222160"
}