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Case Reports
. 2017 May 12:2017:bcr2017220346.
doi: 10.1136/bcr-2017-220346.

A seizure-induced T8 burst fracture re-presenting as an acute abdomen

Radford Arran James Smith  1 , Nigel Poland  1 , Simon Cope  1
Affiliations
Case Reports

A seizure-induced T8 burst fracture re-presenting as an acute abdomen

Radford Arran James Smith et al. BMJ Case Rep. .

Abstract

A male aged 44 years presented to the emergency department with a 1-week history of intermittent right-sided abdominal pain radiating to the midline. Examination demonstrated a tender right upper quadrant with voluntary guarding and a low grade fever. One week previously, he had been admitted to hospital after an isolated, self-terminating seizure secondary to an deliberate venlafaxine overdose. His upper abdominal symptoms started immediately postseizure but at the time were attributed to musculoskeletal chest pain by the discharging team. Acute cholecystitis was suspected, but liver function tests, amylase and an erect chest radiograph were unremarkable.The abdominal pain responded well to morphine, permitting a thorough reassessment of the patient, which revealed midthoracic spine tenderness, previously undetected. Prior to this, the patient had not complained of any back pain. A CT scan confirmed a burst fracture of T8 requiring urgent transfer to the local spinal unit for posterior stabilisation.

Keywords: Epilepsy and seizures; General surgery; Orthopaedics; Trauma.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
A CT sagittal (left) and axial (right) image showing an unstable T8 burst fracture with an associated kyphotic deformity.
Figure 2
Figure 2
An intraoperative lateral radiograph showing the cage and posterior stabilisation of T8.
See this image and copyright information in PMC

References

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