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Results for “SPLENIC INFARCTION”

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At least 19 recordsLinked to original sources
PubMed1985

Splenic infarction, splenic sequestration, and functional hyposplenism in hemoglobin S-C disease.

Splenic atrophy or evidence of hyposplenism occurs in as many as one third of all patients with S-C hemoglobinopathy. Yet there are few reports in the literature of clinically apparent splenic infarction in this disease. We describe four instances of acute splenic infarction in three patients with hemoglobin S-C disease which illustrate a wide spectrum of clinical manifestations and severity. Of particular interest were the observations of coincident occurrences of splenic sequestration and functional hyposplenism with splenic infarction, suggesting a close pathophysiological relationship among these syndromes.

Adult↗
PubMed1986

Thromboembolic splenic infarction.

Splenic infarction occurs as a consequence of systemic thromboembolization in association with several cardiovascular disorders. We describe a case of splenic infarction in a patient who had paroxysmal atrial fibrillation after aortic valve replacement. In an autopsy series of 96 consecutive cases of splenic infarction, only 10% had been suspected clinically even though the splenic infarctions had contributed substantially to morbidity and mortality in 44% of the cases. Thromboembolic causes were responsible for the splenic infarcts in 67% of the cases, and concomitant infarcts in other organ systems were found in 62%. Embolization of atheromatous debris from the aorta, thrombotic elements from the left ventricle (in dilated cardiomyopathy and acute myocardial infarction), and vegetations from infected valves are the most common settings in which thromboembolic splenic infarcts are noted. The clinical picture associated with splenic infarction is typically nonspecific; manifestations may include fever, tachycardia, and left-upper-quadrant tenderness. Computed tomographic scanning and, to a lesser degree, ultrasonography are the imaging techniques of choice for diagnosing splenic infarction.

Aortic Valve Stenosis↗
PubMed1989

[Splenic infarction].

Splenic infarction is a recognized sequel of a number of diseases but, until recently, it has been difficult to verify. Employing the new imaging techniques, the spleen has become diagnostically more accessible and increase in the number of splenic infarctions diagnosed must be anticipated. The commonest basic cause is cardiovascular disease but the etiology may be manifold. Whereas the infarct as such is of lesser significance, splenic abscess, eg after bacterial endocarditis, is a life-threatening condition. The treatment consists of surgical drainage and, frequently, splenectomy. The lethality is reduced from nearly 100% to approximately 10% when the correct treatment is employed.

Humans↗
PubMed1977

Unusual cause of acute abdomen. Sickle cell trait and nonhypoxic splenic infarction.

Splenic infarction under hypoxic conditions is a well-known complication of sickle cell trait (Hgb AS). However, this case illustrates that it may occur without any clinical conditions of circumstances associated with decreased Pao2. In addition, sickle cell trait should be included in the differential diagnoses of splenic infarction even if the patient is not of African ancestry.

Abdomen, Acute↗
PubMedDate not supplied

A rare cause of acute abdomen: splenic infarction.

Splenic infarction is a rare disorder. We have treated 4 patients during the last year. Abdominal pain in the left upper quadrant was the common complaint. Other complaints were fever, nausea and vomiting. Computed tomography showed infarcted areas in the spleen in all of the patients. Splenectomy was applied to three of the patients with recurring symptoms. The other patient had the first episode treated medically. Pulmonary embolism in one and surgical wound infection occurred in another patient during postoperative follow-up for nine (range: 4-14) months.

Abdomen, Acute↗
PubMed1991

Case report: splenic infarction and acute splenic sequestration in adults with hemoglobin SC disease.

While acute splenic sequestration and splenic infarction are commonly observed in infants and young children with sickle cell anemia, they are rarely experienced by adult hemoglobin S homozygotes because the recurrent splenic infarction that takes place during childhood is typically followed by scarring, atrophy, and splenic fibrosis. Both acute splenic sequestration and splenic infarction do remain relatively common in adults with the other sickle hemoglobinopathies. These episodes are almost certainly a consequence of the persistently enlarged and distensible spleens that often remain present in these conditions. In this report, the authors describe two adult patients with hemoglobin SC disease: one who developed acute splenic sequestration and one with splenic infarction. In neither case was there a history of recent air travel or exposure to altitude. The clinical course of these two syndromes is presented, and the hematologic, radiologic, and pathologic manifestations are discussed. Because they can sometimes be difficult to distinguish from one another, and because a failure to identify acute splenic sequestration can be catastrophic, these two entities must be included in the differential diagnosis for any hemoglobin SC patient who present with an unexplained fall in hemoglobin, left upper quadrant pain, unexplained fever, or symptomatic splenomegaly.

Acute Disease↗
PubMed1993

Liver/spleen scintigraphy for diagnosis of splenic infarction in cirrhotic patients.

Splenic infarction is rare in cirrhotic patients. The diagnosis of the condition is based on clinical findings and splenic imaging. In recent years, ultrasonography and computed tomographic scan have gained popularity over the more classical scintigraphy as the preferred investigations for the diagnosis of splenic infarction. We report three cases of splenic infarction in patients with cirrhosis and portal hypertension. Computed tomographic scan, angiography and ultrasonography failed to identify the lesions and the diagnoses were finally made with the aid of liver--spleen scintigraphy. We suggest that scintigraphy is the investigation of choice if splenic infarction is suspected in patients with congestive splenomegaly secondary to liver cirrhosis.

Adult↗
PubMed1998

The clinical spectrum of splenic infarction.

Two recent cases of splenic infarction of unusual cause stimulated a review of our experience with this condition. We conducted a retrospective chart review of selected patients with pathologic diagnosis of splenic infarction seen at a large metropolitan private teaching hospital during the past 30 years. Variables analyzed included sex, age, etiology of infarction, underlying diseases, diagnostic tests, splenic pathology, and complications. Splenic infarction occurred in 59 patients (33 male and 26 female; average age, 55 years; range, 2-87 years). Etiologies included hematologic disorders (n = 35), thromboembolic disorders (n = 17), and other diseases (n = 7). Symptoms were present in 69 per cent of the patients and included abdominal pain, fever and chills, and constitutional symptoms; 18 patients were asymptomatic. Patients with nonmalignant hematologic conditions were often asymptomatic (55%); abdominal pain was common in all groups, and fever was especially common in patients with embolic conditions (70%). CT scan was the most frequent radiologic study. Patients with hematologic conditions usually were explored for complications of those conditions (69%), while complications of splenic infarction were a frequent indication for operation in patients with emboli (60%). Overall morbidity was 36 per cent, with pulmonary complications most frequent, and mortality was 5 per cent. We conclude that splenic infarction must be suspected in patients with known hematologic or thromboembolic conditions who develop left upper quadrant pain and signs of localized or systemic inflammation. CT scan is currently the preferred diagnostic test, but ultimate diagnosis depends on pathologic examination of the spleen. Surgical complications of splenic infarction include abscess and rupture.

Adolescent↗
PubMed1982

Computed tomography in the diagnosis of splenic infarction.

The demonstration of splenic infarction by computed tomographic scanning is described in the following report. CT yields a characteristic pattern which is highly diagnostic. The role of angiography and scintigraphy in splenic infarction is discussed.

Adult↗
PubMed1985

[Splenic infarct in the computed tomogram].

Splenic infarcts are represented by wedge-shaped, oval or linear areas. Haemorrhagic infarcts are characterised by being hyperdense. Disseminated infarction occurs predominantly in myeloproliferative diseases. During the early stages, the infarct appears as an ill-defined hypodense defect, with non-homogeneous contrast enhancement. During the acute and sub-acute stage, the density of the infarct is low and there is no contrast enhancement. During the chronic stage, its density increases and there is slight contrast enhancement. Complications following splenic infarcts, such as abscesses, bleeding and rupture can be demonstrated by CT with great accuracy. Problems in differential diagnosis may occur if there are atypical manifestations of the infarct, with respect to abscess or leukaemic infiltrations.

Abdomen, Acute↗
PubMed2002

Massive splenic infarction in Saudi patients with sickle cell anemia: a unique manifestation.

Splenic infarcts are common in patients with sickle cell anemia (SCA), but these are usually small and repetitive, leading ultimately to autosplenectomy. Massive splenic infarcts on the other hand are extremely rare. This is a report of our experience with 8 (4 males and 4 females) cases of massive splenic infarction in patients with SCA. Their ages ranged from 16 to 36 years (mean 22 years). Three presented with left upper quadrant abdominal pain and massive splenic infarction on admission, while the other 5 developed massive splenic infarction while in hospital. In 5 the precipitating factors were high altitude, postoperative, postpartum, salmonella septicemia, and strenuous exercise in one each, while the remaining 3 had severe generalized vasoocclusive crises. Although both ultrasound and CT scan of the abdomen were of diagnostic value, we found CT scan more accurate in delineating the size of infarction. All our patients were managed conservatively with I.V. fluids, analgesia, and blood transfusion when necessary. Diagnostic aspiration under ultrasound guidance was necessary in two patients to differentiate between massive splenic infarction and splenic abscess. Two patients required splenectomy during the same admission because of suspicion of secondary infection and abscess formation, while a third patient had splenectomy 2 months after the attack because of persistent left upper quadrant abdominal pain. In all the 3 histology of the spleen showed congestive splenomegaly with massive infarction. All of our patients survived. Two patients subsequently developed autosplenectomy while the remaining 3 continue to have persistent but asymptomatic splenomegaly. Massive splenic infarction is a rare and unique complication of SCA in the Eastern Province of Saudi Arabia, and for early diagnosis and treatment, physicians caring for these patients should be aware of such a complication.

Adolescent↗
PubMedDate not supplied

Splenic infarction in 16 dogs: a retrospective study.

Sixteen dogs with splenic infarction due to causes other than splenic torsion were identified. Dogs with splenic infarction often had multiple concurrent diseases, and surgical management of splenic infarction was associated with high mortality. Splenic infarction occurred in dogs with hypercoagulable conditions associated with liver disease, renal disease, and hyperadrenocorticism, or as a consequence of uniform splenomegaly, neoplasia, or thrombosis associated with cardiovascular disease. Clinical signs and common laboratory findings generally reflected the underlying disease process. A variety of splenic abnormalities were detected by abdominal ultrasound in 15 dogs, with the ventral extremity of the spleen being most often abnormal. Four dogs were euthanized or died because of the presence of severe systemic disease, whereas 12 dogs underwent laparotomy. Complete splenectomy was performed in 9 dogs and partial splenectomy was performed in 2 dogs. Seven dogs died in the immediate postoperative period, 3 required chronic veterinary care, and 2 had uncomplicated long-term recoveries. Splenic infaraction should be regarded as a sign of altered blood flow and coagulation, rather than as a primary disease, and surgical management should be reserved for patients with life-threatening complications such as hemoabdomen or sepsis.

Animals↗
PubMed1999

Splenic infarction in pregnancy.

We present a case of splenic infarction in pregnancy, secondary to acute bacterial endocarditis. Left upper quadrant pain in pregnancy can be due to a variety of causes and in the septic or unwell patient, splenic infarct should be considered in the differential diagnosis. The diagnosis of splenic infarct should be considered especially in those at increased risk of bacterial endocarditis. Acute bacterial endocarditis can occur even in patients without any risk factors. Bacterial endocarditis is rare in pregnancy and splenic infarction is even rarer. However when it occurs, rapid diagnosis and management are necessary to minimize embolic phenomena. With the increasing use of intravenous drugs and with increasing numbers of Pacific Islanders in our pregnant population, it is important to be alert to the risk of bacterial endocarditis and to avoid serious sequelae. Patient education to the importance of medical follow-up in order to prevent such a life-threatening condition, and to avoid more complicated acute treatment, is imperative.

Adult↗
PubMedDate not supplied

Acute, complete splenic infarction in cancer patient is associated with a fatal outcome.

Splenic infarction frequently occurs in patients with myeloproliferative diseases, endocarditis, and sickle cell anemia. Various sonographic patterns of splenic infarction do exist. but little is known about tumor associated splenic infarction in cancer patients. Between January 1992 and December 2002, 66 patients were diagnosed with splenic infarction by color Doppler sonography (CDS). Ten patients had an underlying solid cancer. Clinical and sonographic data of cancer patients were evaluated retrospectively with regard to age, sex, frequency of thrombotic episodes, splenic size, echomorphology and vascularity of splenic lesions, and follow-up examination. The median age was 53 years (range, 16-73 years). Nine of 10 patients had abdominal metastases, four had evidence of a hypercoagulable state, five had a small spleen (< 7 x 3 cm), and seven had acute complete infarction of the spleen without hilar and parenchymal vessels on CDS. Survival of six patients with acute complete infarction ranged from 1 to 30 days. In cancer patients with splenic infarction, an acute complete infarction is the most common pattern. It is caused predominantly by a hypercoagulable state and is associated with an extremely short survival.

Acute Disease↗