DOULEUR ÉPIGASTRIQUE SPONTANÉE RÉVÉLANT UNE RUPTURE D’ANÉVRISME DE L’ARTÈRE SPLÉNIQUE. UNE PATHOLOGIE RARE ET GRAVE PEU ÉVOQUÉE AUX URGENCES

Abstract

Abdominal pain is a frequent admission motive in any emergency department. They represent 4 to 10% of all consults. The diagnosis is often enlightened by a well conducted anamnesis and physical exam. The localisation of the pain can also orient the diagnostic hypothesis. Epigastric pain occurring without any traumatism are usually related to pathologies of the digestive tract (gastroduodenal ulcers, pancreatitis, gull bladder diseases, or even sub-hepatic appendicitis or mesoceliac appendicitis) or cardiac pathololgies (infarct), and sometimes pulmonary or pleural diseases. Aneurysm rupture among young patients without any vascular condition is never evoked in the first place. However, a good diagnostic walkthrough and progressive elimination of other etiologies have to make you think of vascular origin of abdominal pain. This diagnosis has to be thought of quickly as soon as during the stay in the emergency department, in order to obtain an immediate surgical treatment. An etiological assessment will of course be necessary once the treatment has been performed.