Fig. 24

Delay in diagnosis with a life-threatening condition. A 47-year-old male patient presented with complaints of chest pain and abdominal discomfort. History and clinical examination suggested cardiovascular etiology as a possible underlying cause. Coronary CTA was ordered to evaluate the presence of coronary artery disease. The coronary arteries were reported as normal. However, a well-defined splenic hypervascular lesion was missed due to the “edge effect”. The lesion was seen only on the last few slices of “the CT images with a large field of view” (red arrow, a). One week later, the patient was admitted to the ER with severe left upper quadrant pain. Abdominal CECT revealed a ruptured lesion (red arrows, B, c) and subcapsular splenic hematoma (blue arrows, b, c) with active extravasation (not shown)