Ultrasound detection of spontaneous rupture of accessory spleen: A case report.

Accessory spleen rupture can induce acute abdominal bleeding following minimal trauma or by atraumatic mechanisms. Spleen rupture is more frequent in pediatric patients and those affected by hematological diseases. We described the case of a 59-year-old male patient affected by hereditary spherocytosis referred to the emergency department for abdominal left side pain. An early ultrasound performed in the emergency department allowed to diagnosed hemoperitoneum by spontaneous bleeding of hypertrophic accessory spleen. Although abdomen computed tomography is the diagnostic method of choice, ultrasound can early detect sign of emoperitoneum in the emergency setting in case of hemodinamically unstable patient.

Cardiovascular and cerebrovascular events pre- and post-earthquake of 6 April 2009: the Abruzzo's experience.

BACKGROUND: On 6 April 2009, an earthquake occurred in Abruzzo, a small region in the middle-east of Italy. Its chief town, L'Aquila, was the epicenter. We carried out an observational analysis to evaluate the potential association between the earthquake and the rate of cardiovascular and cerebrovascular admissions of the residents in the province of L'Aquila. METHODS: We used administrative discharge data, extracting all admissions made from 6 April to 31 July 2008 (pre-earthquake control period) or from 6 April to 31 July 2009 (post-earthquake period), assigned to diagnosis-related groups (DRGs) related to cardiovascular or cerebrovascular diseases. RESULTS: The overall number of hospitalizations for cardio- or cerebrovascular diseases by residents in L'Aquila before and after the earthquake was 10,833. In the whole region, the hospitalization rate was slightly lower in 2009 (-0.9%), whereas only in the local health unit (LHU) of L'Aquila it showed an increase by +13.2% (P < 0.01), essentially due to cardiovascular diseases (+21.9%) in elderly people (+26.9%; P < 0.01). The proportion of the main comorbidities in the admissions for cardiovascular diseases of the residents in L'Aquila significantly increased (P = 0.03), but no significant differences could be observed for each comorbidity separately. CONCLUSIONS: Our study supports previous findings of an association between earthquakes and an increase in cardiovascular diseases in the elderly.