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PubMedDate not supplied

[Splenic infarction caused by vascular pedicle torsion].

We report a case of a spleen infarction caused by the vascular pedicle torsion. A 25 year-old-man, heterozygous for HbS, presented with severe abdominal pain especially in the left upper quadrant in front and in the back, fever other symptoms related to acute abdomen. First we excluded most common disease (occlusive one and hematologic one) through conform investigation, then we suspected a spleen problem. So we did further investigation with ultrasonography which showed splenomegaly and the spleen looked twisted with its hilum in contact with previous abdominal wall, moreover (here were are as of decreased signal intensity characteristic of splenic infarction under the capsule and some blood in the Douglas pouch. The patient underwent splenectomy urgently. During the intervention we saw a splenomegaly like the ultrasonography showed, moreover there were a long twisted vascular pedicle and many areas of infarctions, some of which had ruptured causing emoperitoneum. The surgical intervention was successful and the clinical spectrum was solved. The splenic infarction might be clinically silent or to represent a surgical emergency. In front a case of acute abdomen, after exclusion of most common etiology, we underline the importance to suspect a spleen suffering, especially vascular one, when (here was no history of trauma. Considering this fact, a simple not invasive examination like ultrasonography is able to confirm this kind of hypothesis and to give soon information to make the surgical choose.

Adult↗
PubMed1996

[Splenic infarction caused by paradoxical emboli in severe pulmonary hypertension].

HISTORY AND CLINICAL FINDINGS: A 55-year-old woman developed increasing shortness of breath and breath-independent pain in the left lower chest. 20 years previously she had had an episode of pulmonary embolism and 10 years previously a central venous thrombosis in the left eye. No cause of the increased thrombogenesis had been found. On admission she had resting dyspnoea but a stable circulation. On auscultation the breath sounds were diminished over the left base and there was a diastolic murmur over the pulmonary area with an accentuated second sound. There was also marked tenderness below the left costal margin. Recurrent pulmonary embolism or left-sided pleuropneumonia was suspected. INVESTIGATION: Arterial blood gases (without additional oxygen) showed severe hypoxaemia (pO2 42.3 mm Hg, pCO2 27.8 mm Hg, pH 7.455, oxygen saturation 80.5%). Transthoracic and transoesophageal echocardiography showed normal left ventricular dimensions, right atrial and ventricular dilatation, and an atrial septal aneurysm with a right to left interatrial shunt. Right heart catheterisation demonstrated severe pulmonary hypertension. Sonography, computed tomography and scintigraphy revealed multiple splenic infarcts. TREATMENT AND COURSE: Heparinisation was instituted (partial thromboplastin time 70-90 s) and overlapping oral anticoagulation to a Quick value of 20%. Subsequently the calcium antagonist felodipine (15 mg daily) was given. The mean pulmonary artery pressure was 61 mm Hg before and 57 mm Hg after treatment. CONCLUSION: Splenic infarction resulting from paradoxical embolisation is rare, but should be routinely considered in the presence of thromboembolic phenomena.

Angiography↗
PubMed1979

Splenic infarction in a white man with sickle cell trait.

We report the third case of splenic infarction from sickle cell trait in a young white man traveling through mountains. Apparently the hypoxemia at 10,800 feet, along with a relatively high hemoglobin S concentration of 40%, interacted with the known conditions of splenic blood flow to cause sickling and infarction, even though our patient was not exercising. The optimal management for this rare complication of sickle cell trait remains unknown, but surgery may not be required for either diagnosis or therapy.

Adult↗
PubMed2003

Acute myelogenous leukemia with splenic infarcts presenting as fulminant multi-organ failure.

A 60-year-old male was admitted with leukopenia, thrombocytopenia, splenic infarcts and a normal peripheral smear. Within few hours he rapidly deteriorated with fatal multi-organ failure. Autopsy revealed massive infiltration of leukemic cells in several organs. Acute myelogenous leukemia should be considered in a patient presenting with unexplained multiorgan failure.

Humans↗
PubMed2006

Spontaneous splenic infarction associated with sumatriptan use.

Triptans are specific agonists of the serotonergic 5-HT(1B/1D) receptors that have increasingly been used in the treatment of migraine and cluster headaches. Though they are generally considered safe, there have been a few reports of myocardial infarction and stroke associated with triptan use. We report a patient who developed spontaneous splenic infarction after the use of sumatriptan for the treatment of migraine headache.

Causality↗
PubMed1988

Histiocytic medullary reticulosis: radiologic diagnosis of splenic infarction--a case report.

A case of histiocytic medullary reticulosis with splenic infaraction from a 23-year-old male is presented. Radiologic findings on selective spleen scintigraphy and abdominal CT are described. Selective spleen scintigraphy showed huge, multilobulated spleen with numerous photon-deficient areas in it and peripherally. Abdominal CT showed large peripheral band-like low density and infiltrative lesion in spleen with accompanying intraabdominal lymphadenopathy. Histoligical features were consistent with HMR in spleen and liver specimens.

Adult↗
PubMed1981

Advanced ovarian cancer with splenic infarct. A case report on diagnostic difficulties and favorable cytotoxic effects.

Findings obtained with and significance of eight methods of diagnosing splenic infarct combined with advanced ovarian cancer are presented. The internal structures of the affected spleen were visualized only by ultrasonography and computer-assisted roentgen-ray tomography, revealing the enlarged spleen with its multilocular fluid-filled structure. Total remission of this poorly differentiated ovarian adenocarcinoma was achieved by combined cytotoxic therapy with adriamycin, f-ftorafur and cisplatinum.

Adenocarcinoma↗