Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Splenic Infarction”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 469 records · Page 26Linked to original sources
PubMedDate not supplied

CT diagnosis of splenic vein occlusion: imaging features, etiology and clinical manifestations.

BACKGROUND: Previous reports have described the computed tomographic (CT) appearance of collateral veins following splenic vein occlusion (SVO). This retrospective study was performed to determine the etiology, clinical manifestations, and accuracy of CT diagnosis in patients with this entity. METHODS: A computer search of radiology reports for a 1-year period found 52 patients with SVO diagnosed by absence of visualization of the splenic vein accompanied by the formation of the expected perigastric collateral veins. Clinical data were reviewed for sequela of SVO and clinical impact of the diagnosis. RESULTS: In 12 cases, other studies confirmed the CT diagnosis of SVO. In no case was the CT diagnosis proved to be incorrect by other imaging studies. Angiographic records found five additional cases with SVO not diagnosed by CT, but two of five had convincing CT evidence of SVO noted upon reevaluation by the authors. Review of clinical data showed heme-positive stool in six, of which three had significant gastrointestinal hemorrhage. Splenic infarction occurred in two cases. CONCLUSIONS: Our data indicate that SVO is more common than previously suspected and usually remains clinically silent, but CT appears to be highly specific and fairly sensitive for its diagnosis.

Collateral Circulation↗
PubMed1982

Menetrier's disease with occlusion of splenic and brachial arteries.

A 40-year-old man presented with occlusion of the left brachial artery and sudden onset of abdominal pain. A radiocolloid scan revealed a fragmented appearance to the spleen. This was found to be due to multiple splenic infarcts. Results of an upper gastrointestinal series and tissue biopsy specimen established the diagnosis of Menetrier's disease. It was noted that at least one report in the literature suggested that vascular occlusions may be part of the natural history of Menetrier's disease.

Adult↗
PubMed1976

Chronic torsion of the spleen.

Wandering spleen may result from congenital failure of splenic attachments or acquired laxity of attachments due to stretching. The wandering spleen is quite vulnerable to the complication of torsion, which is seen most often as an acute abdominal emergency due to splenic infarction. A more unusual variant is chronic torsion which causes intermittent mild to moderate abdominal pain, gastrointestinal disturbances and, in one case, hypersplenism. A mass has been present in most cases and may be anywhere in the abdomen or pelvis. Splenectomy should be performed for all cases of wandering spleen with or without torsion.

Adolescent↗
PubMed1995

Case report: bleeding gastric varices secondary to splenic vein thrombosis successfully treated by splenic artery embolization.

Splenic vein thrombosis is a complication of pancreatic carcinoma or pancreatitis. It may lead to gastric varices which are difficult to treat and splenectomy may be required to stop variceal bleeding. A case of bleeding gastric varices secondary to splenic vein thrombosis and successfully treated by splenic artery embolization is reported. Embolization was performed by transcatheter deposition of four Gianturco coils into the splenic artery. This resulted in reduced blood flow through the spleen with partial splenic infarction and cessation of variceal bleeding. There has been no recurrence of bleeding in the 6 months since the procedure. Literature review confirms that experience of using this treatment is very limited and it should therefore be restricted to patients at high risk from surgery.

Embolization, Therapeutic↗
PubMed1990

Partial splenic embolization. An effective alternative to splenectomy for hypersplenism.

Splenectomy for massive splenomegaly and hypersplenism carries a significant morbidity and mortality. We have used partial splenic embolization (PSE) as an effective alternative to splenectomy. Ten PSE procedures were performed on nine patients without mortality and with minimal morbidity. The age of the patients ranged from 8 months to 32 years (mean 14 years). The causes of splenomegaly and hypersplenism included cystic fibrosis with cirrhosis (2), tyrosinemia and cirrhosis (1); thalassemia (1), hemophilia with Human Immune Deficiency Virus infection (2), chronic hepatitis with portal hypertension (1), malignant histiocytosis (1), and Wiskott-Aldrich Syndrome (1). All procedures were performed under local anesthesia with sedation. A percutaneous femoral artery approach to the splenic artery was used to deliver Ivalon sponge particles (280-800 microns) into the spleen. Splenic infarction was assessed by postembolization angiograms. All of the patients except one demonstrated improvement of hematologic parameters. In one patient, however, cytopenia improved only after a second embolization. In the total series, there was an early mean rise of 8,600/mm3 in the leukocyte count (range 2,900-14,900) and 212,000/mm3 in the platelet count (range 30,000-718,000). Follow-up ranged from 4 months to 7 years. Improvement of the blood picture has been persistent in seven of the eight patients who showed initial improvement. Transient procedural complications included fever (5), pleural effusion (2), pneumonia (1), and splenic abscess (1). One patient had paralytic ileus lasting for 10 days and one patient developed a streptococcal peritonitis 3 weeks after embolization. No patient developed pancreatitis or vascular compromise of other abdominal viscera.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

Splenic pseudoaneurysm rupture into the colon: colonoscopy before and after successful arterial embolization.

We report a case of splenic pseudoaneurysm rupture into the colon in chronic pancreatitis. At the time of bleeding, pancreatitis was undiagnosed and the colonic lesion was misinterpreted at colonoscopy. The lesion was also misinterpreted at laparotomy, because it simulated intra-abdominal carcinomatosis. The diagnosis was made by CT examination which showed an eccentric enhancing region within a hypodense mass in the region of the splenic hilum. Definitive control of bleeding was achieved by splenic arterial embolization. Splenic infarction and an intrasplenic abscess complicated the embolization, but they did not require surgical intervention. Healing of the colonic wall and of the colonic mucosa was observed at colonoscopy 3 weeks after the embolization.

Aneurysm↗
PubMed2001

Imaging findings in the rare catastrophic variant of the primary antiphospholipid syndrome.

We report imaging findings in a case of the rare catastrophic variant of antiphospholipid syndrome (CAPS) characterized by widespread microvascular occlusions, which may lead to multiple organ failure. We present a case of a 66-year-old woman with bone marrow necrosis, acute acalculous cholecystitis (AAC), focal liver necrosis, subtle patchy splenic infarctions, and bilateral adrenal infarction. The demonstration of multiple microvascular organ involvement (three or more) is crucial for the diagnosis of the catastrophic variant of APS. This can be performed radiologically intra-vitam. Imaging can even reveal subclinical microinfarctions, which are often only diagnosed at autopsy.

Aged↗
PubMed2006

[Low-MI-sonography with the contrast-agent SonoVue in the diagnosis of infarction of the spleen, kidney, liver and pancreas].

PURPOSE: The diagnosis of ischemic injury by B-mode-sonography is difficult in many cases. Aim of the pilot-study was to evaluate whether additional examination with the ultrasound contrast agent SonoVue could improve the sonographic diagnosis of ischemic injury. MATERIALS AND METHODS: In a prospective study, intra-abdominal organs (n = 12) with ischemic lesions found by CT-scan were examined. All ischemic organs were examined by native B-mode-sonography and after injection of 1.2 ml SonoVue i. v. The SonoVue-examinations were performed using the CPS-software (Siemens, Erlangen). RESULTS: Native B-mode-sonography detected demarcation of ischemic lesions in only 7 of the 12 organs. In contrast, SonoVue-enhanced sonography diagnosed ischemic lesions in all organs. In one patient with renal infarction, however, the ischemic lesion found by SonoVue-enhanced sonography was smaller compared with the CT-scan. The diagnosis "compatible with ischemia" as cause for the abnormalities in B-mode sonography was described in only 3 out of 12 organs, and none of the organs were classified as "definite diagnosis of ischemia". In contrast, the diagnosis "definite diagnosis of ischemia" was made in 10 of the 12 organs when examined with SonoVue-enhanced sonography. In two further patients, the lesion was classified as "compatible with ischemia". In these patients, the diagnosis of ischemia was verified by CT-scan, due to the accompanying subtotal splenic infarction and a partial thrombosis of the coeliac trunc. CONCLUSION: It became evident that SonoVue-enhanced sonography was more sensitive in the diagnosis of ischemic injury than native B-mode sonography.

Abdomen, Acute↗
PubMed1985

[Splenic abscess disclosing endocarditis].

A 54 year old man, hospitalised for thoraco-abdominal pain resulting from a septicemia which gives positive hemocultures for streptococcus D Bovis, is diagnosed to have a splenic abscess which will require splenectomy. At the same time, an endocarditis develops and gets worse, with auriculo-ventricular blockade and, especially, major aortic insufficiency, which is the cause of death by a brutal and massive pulmonary oedema. In the progression of an endocarditis, the occurrence of a splenic abscess, primary localisation of the initial septicemia or the secondary of an arterial septic embolism, is a rare contingency compared to the frequency of splenomegaly or splenic infarction: less than 2 percent of the cases in the literature. This very atypical and exceptional case serves as a reminder, on the one hand, of the diagnostic inadequacy of echocardiography which cannot visualise vegetation in the course of progressive endocarditis, and, on the other, of the prognostic importance of auriculoventricular blockade in septal and aortic endocardial lesions.

Abscess↗
PubMed2000

US and CT findings in splenic focal lesions in AIDS.

PURPOSE: To evaluate the role of US and CT in focal splenic lesions in AIDS patients in relation to etiology. MATERIAL AND METHODS; A total of 66 patients with AIDS and focal splenic lesions were examined with sonography. CT with administration of contrast medium was performed in 12 cases. RESULTS: Of the focal splenic lesions, 67% were correlated with an infective pathology with prevalence of Mycobacteria tuberculosis (75%), 26% were neoplastic and 6% splenic infarcts. The lesions were hypoechoic in 60% of the cases, while 10% were hypoanechoic and 1% anechoic. At CT, all lesions appeared hypodense, even after i.v. administration of contrast medium. CONCLUSION: The combination of echographic reports and clinical and laboratory data allows for a diagnosis that can be confirmed, and making a decision for effective therapy of AIDS is possible. CT does not provide any additional information.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Transient neutrophil aggregation in a patient with infectious mononucleosis.

Transient neutrophil aggregation is reported in a case of infectious mononucleosis. The phenomenon was observed on a blood film patient just before splenic infarction and decreased after splenectomy. The aggregation was so important that differential blood count could not be done. A high serum level of circulating immune complexes was found, and fluorescent spots inside of granulocytes, presumably engulfed immune complexes, could be observed. It is suggested that C activation associated with high immune complexes in infectious mononucleosis is a possible pathogenetic mechanism inducing PMNs aggregation and immune tissue damage.

Adult↗
PubMed1999

Hepatosplenic B-cell lymphoma associated with hemophagocytic syndrome: a case report.

While T-cell non-Hodgkin's lymphoma (NHL) associated with hemophagocytic syndrome (HPS) has been frequently observed, B-cell NHL associated with HPS has been rarely reported. We report a case of hepatosplenic B-cell lymphoma associated with HPS in a 41-year-old woman who presented with fever of unknown origin. An abdominal CT scan revealed splenomegaly with focal splenic infarction. Splenectomy and a liver wedge biopsy showed sinusoidal-pattern infiltration of medium to large tumor cells with positive reaction to a B-lymphocyte marker. Findings on bone marrow examination showed proliferation of histiocytes with avid hemophagocytosis.

Adult↗
PubMed1996

Unresolved issues in laparoscopic splenectomy.

BACKGROUND: Laparoscopy is now expanding to surgery of intra-abdominal solid organs such as splenectomy for hematologic diseases. The purpose of this study is to further demonstrate that laparoscopic splenectomy is feasible for the surgeon, teachable for the resident, and beneficial to the patient and to revise prior contraindications to this minimally invasive approach. METHODS: Thirty-three consecutive cases of laparoscopic splenectomy were performed between May 1992 and March 1996. The series included 21 females and 12 males with a median age of 42 years (range 19-79) and a median weight of 73 kg (range 36-115). Indications included: immune thrombocytopenic purpura (20), hemolytic anemia (5), hereditary spherocytosis (4), infarction with abscess (1), Hodgkin's lymphoma (1), Gaucher's disease (1), and AIDS-related thrombocytopenia (1). Dissection was predominately performed with a new surgical instrument, the harmonic shears, and main vessels were controlled with clips. RESULTS: Thirty-two (97%) of the cases were completed laparoscopically, with 1 (3%) conversion to control hilar bleeding. Four patients underwent simultaneous cholecystectomy. The median spleen size was 13 cm (range 8-28) and median weight was 256 g (range 40-2100). Median operating time was 242 minutes (range 85-515). Morbidity occurred in 2 (6%) patients: ileus and small bowel obstruction. Median hospital stay was 4 days (range 2-14). There was no mortality in our series. Median follow-up was 20 months (range 1-46) with no evidence of late surgical complication or recurrent disease. CONCLUSION: Laparoscopic splenectomy may be successful in cases previously considered contraindicated, particularly splenomegaly and splenic infarct with abscess. It is a procedure that can be learned under appropriate guidance in academic centers.

Adult↗
PubMed1993

[Long-term prognosis of idiopathic thrombocytopenic purpura treated by partial splenic embolization].

The therapeutic effect of partial splenic embolization (PSE) was evaluated in 13 patients with idiopathic thrombocytopenic purpura (ITP). Eight patients were treated by PSE and followed up over 6 months after the treatment. Two patients were treated by splenectomy following PSE. (1) PSE achieved complete remission in one case, partial response in 3 cases, minimal response in one case and no change in 3 cases. PSE resulted in 62.5% of the effective rate. (2) The effect of PSE did not depend on age, sex, the duration of disease, platelet count and PA-IgG level before the treatment and the splenic infarcted rate. The platelet count after PSE increased more remarkably in the effective cases than in the non-effective ones (p < 0.01), which could predict the prognosis after PSE. (3) One patient whose platelet count increased enough after PSE had splenectomy later and resulted in complete remission. However another patient whose platelet count did not increase enough after PSE revealed no effect by splenectomy. PSE for the treatment of ITP could prevent some patients from non-effective splenectomy and achieve the same effective rate as splenectomy. Therefore, PSE could be an alternative therapy of splenectomy because of the less invasive one.

Adolescent↗
PubMed2002

Emergency laparoscopic splenectomy for "wandering" (pelvic) spleen: case report and review of the literature on laparoscopic approach to splenic diseases.

Wandering spleen (WS) is a rare condition where the spleen, free from its ligaments, is allowed to move inside the abdomen predisposing the patient to life-threatening complications due to torsion of the vascular pedicle; splenic infarction, portal hypertension, bleeding and acute abdomen may occur. WS is rarely suspected at presentation since symptoms are usually not specific and definitive diagnosis is usually reached only by imaging technologies such as color flow ultrasonography and angio-spiral computer tomography. A 42-year-old woman was referred to our institute from the Emergency and Accident ward, complaining of a sudden onset of sharp abdominal pain together with nausea and vomiting. At examination a large, painful mass was present on the left middle-lower abdominal quadrant. A pelvic spleen was revealed at abdominal ultrasonography (US) and confirmed by abdominal CT. Emergency laparoscopy was carried out. The spleen was barely attached to the peritoneum of the anterior abdominal wall, covered by the greater omentum, the small bowel, and the transverse colon. Once mobilization of the spleen was concluded, the vascular pedicle appeared torted and thrombosed and laparoscopic splenectomy was performed. The patient was discharged on the 4th postoperative day with no complications. To date, only 5 cases of laparoscopic approach to WS have been reported. A review of the literature confirms that the reduction of postoperative stay, wound complications, and overall morbidity and a faster return to normal activity make laparoscopy the "gold standard" approach to the spleen as for treatment of many hematological disorders or more unusual splenic diseases.

Abdominal Pain↗
PubMed2003

Role of phlebotomy in the management of hemoglobin SC disease: case report and review of the literature.

Marked variability is a keynote in the disease course of patients with hemoglobin SC (Hb SC) and hemoglobin S/beta(+)-thalassemia (Hb S/beta(+)-thal), with some patients having a frequency of complications and painful episodes similar to patients with homozygous sickle cell (Hb SS) disease. One possible explanation is that the higher hematocrit in these syndromes may contribute to an increase in blood viscosity, leading to vaso-occlusive pain episodes as well as an increased incidence of thromboembolic complications and retinopathy. We present a patient with Hb SC disease with an excellent baseline functional status who developed splenic infarction at a high altitude. Following splenectomy, the patient developed a sustained increase in hematocrit, an increase in the frequency of painful episodes, as well as new-onset dizziness and malaise. We initiated a therapeutic phlebotomy program in order to lower the hematocrit to pre-splenectomy values, as well as to induce iron deficiency. Repeated phlebotomy resulted in a dramatic decrease in symptoms. Our patient no longer requires narcotic analgesics for pain, has resolution of constitutional symptoms, and has not required further hospitalizations for vaso-occlusive pain crises. The correlation between symptoms and hematocrit levels supports the importance of blood viscosity in contributing to this patient's symptoms. A trial of phlebotomy to reduce viscosity in patients with higher hematocrit values should be considered as an intervention for symptomatic patients with sickle cell disease.

Adult↗