Splenic infarction

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Splenic infarction
Splenic infarct seen on CT
SpecialtyGeneral surgery

Splenic infarction is a condition in which blood flow supply to the

blood clot.[3]

In one series of 59 patients, mortality amounted to 5%.

bleeding, an abscess of the spleen (for example, if the underlying cause is infective endocarditis) or pseudocyst formation. Splenectomy may be warranted for persistent pseudocysts due to the high risk of subsequent rupture.[4]

Diagnosis

Although it can occur

left upper quadrant of the abdomen, sometimes radiating to the left shoulder. Fever and chills develop in some cases.[3] It has to be differentiated from other causes of acute abdomen
.

An abdominal CT scan is the most commonly used modality to confirm the diagnosis,[3] although abdominal ultrasound can also contribute.[5][6][7]

Treatment

There is no specific treatment, except treating the underlying disorder and providing adequate

pain relief. Surgical removal of the spleen (splenectomy) is only required if complications ensue; surgical removal predisposes to overwhelming post-splenectomy infections.[8]

Causes

Splenic infarct seen on CT
Healed splenic infarct

Several factors may increase the

cytomegalovirus infection,[10] malaria,[11] or babesiosis[12]), inherited clotting disorders (thrombophilia, such as Factor V Leiden, antiphospholipid syndrome), malignancy (such as pancreatic cancer) or metastasis, or a combination[13]
of these factors.

In some conditions, blood clots form in one part of the circulatory system and then dislodge and travel to another part of the body, which could include the spleen. These

patent foramen ovale, endocarditis or cholesterol embolism
.

Splenic infarction is also more common in hematological disorders with associated

sickle cell anemia. Both splenomegaly and a tendency towards clot formation feature in this condition. In sickle cell disease, repeated splenic infarctions lead to a non-functional spleen (autosplenectomy
).

Any factor that directly compromises the splenic artery can cause infarction. Examples include abdominal traumas,

tumor. It can also be a complication of vascular procedures.[14]

Splenic infarction can be due to vasculitis or disseminated intravascular coagulation. Various other conditions have been associated with splenic infarction in case reports, for example granulomatosis with polyangiitis[15] or treatment with medications that predispose to vasospasm or blood clot formation, such as vasoconstrictors used to treat esophageal varices, sumatriptan[16] or bevacizumab.[17]

In a single-center retrospective cases review, people who were admitted to the hospital with a confirmed diagnosis of acute splenic infarction,

cryptogenic.[18]

Therapeutic infarction

Splenic infarction can be induced for the treatment of such conditions as

blood loss
.

References

  1. PMID 28613652
    , retrieved 2019-02-27
  2. PMID 3764696
    .
  3. ^
    PMID 9486895
    .
  4. PMID 8371303
    .
  5. S2CID 31332720
    .
  6. PMID 3773568
    .
  7. PMID 8997756
    .
  8. PMID 18510036
    .
  9. S2CID 36770769
    .
  10. PMID 29158925
    .
  11. PMID 15550267
    .
  12. PMID 18171204
    .
  13. S2CID 2702794
    .
  14. PMID 18684317
    .
  15. PMID 26817911
    .
  16. PMID 16767537
    .
  17. PMID 17138227
    .
  18. ^
    PMID 26356690
    .
  19. PMID 15761342
    .

External links

Retrieved from "https://en.wikipedia.org/w/index.php?title=Splenic_infarction&oldid=1188197924"