BMJ Case Reports 2017; doi:10.1136/bcr-2017-220346
  • Unusual association of diseases/symptoms

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

  1. Simon Cope
  1. Emergency Medicine, Torbay and South Devon NHS Foundation Trust, Torquay, UK
  1. Correspondence to Dr Radford Arran James Smith, radford.smith{at}
  • Accepted 1 May 2017
  • Published 12 May 2017


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.


  • Contributors RAJS was responsible for the conception, design and writing of the article and acquisition of images. NP helped to critically revise the article. SC helped to critically revise and approve the final version of the article.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Register for free content

The full text of all Editor's Choice articles and summaries of every article are free without registration

The full text of Images in ... articles are free to registered users

Only fellows can access the full text of case reports (apart from Editor's Choice) - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource

Don't forget to sign up for content alerts so you keep up to date with all the case reports as they are published, and let us know what you think by commenting on the Editor's blog

Navigate This Article