Splenic Laceration and Pulmonary Contusion Injury From Bean Bag Weapon
A 58-year-old male with schizophrenia presented to the emergency department after being shot by law enforcement with two bean bag rounds. He was shot once in the upper abdomen. He reportedly turned and was shot again in the left flank; both shots were at an estimated distance of twenty feet. On arrival, the patient’s blood pressure was 84/52 and heart rate was 121 beats per minute. The patient was agitated and given 5mg intramuscular (IM) haloperidol, 50 mg IM diphenhydramine, and 1 mg intravenous lorazepam. The patient’s chest and back exam revealed a 2.5 cm abrasion and contusion to the left flank (). His lung examination was normal. His abdomen was thin, soft, and non-tender. He had another 2.5 cm circular abrasion to the upper abdomen/epigastrum (). Initial hemoglobin was 13.4 g/dL. We performed Focused Assessment with Sonography for Trauma examination, which demonstrated free fluid in Morison’s pouch () and the suprapubic window. The splenorenal space did not show any fluid.\nComputed tomography of the abdomen and pelvis with intravenous contrast revealed the following: a moderately displaced fracture of the left 11th rib, buckle fracture of the left 12th rib, trace left anterior inferior pneumothorax, American Association for the Surgery of Trauma grade 4 splenic laceration () with moderate perisplenic hematoma, mild perihepatic hematoma, and anterior abdominal wall/rectus sheath hematoma.