Left-Upper-Quadrant Mass Following Trauma

Abstract

Dr. Milton A. Weiner: A 15-year-old girl came to the hospital complaining of persistent left-upper-quadrant pain of four days' duration, following a fall while skating. Physical examination showed a listless, pale girl who was mildly uncomfortable but in no acute distress. There was a tender left-upper-quadrant mass extending 5 cm below the left costal margin. Her hematocrit reading was 29%. Discussion Dr. Laurence L. Robbins: Dr. Weber, will you discuss this case? Dr. Alfred L. Weber: There is evidence of an increased density in the left-upper-quadrant, with slight inferior displacement of the splenic flexure and obliteration of the left psoas shadow (Fig 1). There is no displacement of the colon from the lateral abdominal wall, and there are no fractures in the lower-rib cage. There appears to be indentation upon the inferior margin of the fluid-filled stomach, which is slightly displaced medially. The spleen cannot be outlined. I think, with