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Splenic infarction
From WikEM
Contents
Background
- Occlusion (clot or infection) of splenic artery or one or more of its sub-branches
Causes
- Hypercoagulable state
- Malignancy
- Antiphospholipid Syndrome
- Embolic disease
- Atrial Fibrillation
- Patent foramen ovale
- Atheromatous disease
- Infective endocarditis
- Myeloproliferative disorders with splenomegaly
- Polycythemia vera
- Essential thrombocythemia
- Primary myelofibrosis
- Sickle Cell Disease
- Any splenomegaly
- Gaucher disease
- Splenic lymphoma
- Splenic Trauma
- Splenic arterial torsion
- Mononucleosis
Clinical Features[1]
- Acute LUQ pain (48%)
- LUQ tenderness (36%)
- Fever (36%)
- Nausea or Vomiting (32%)
- Splenomegaly (32%)
- Elevated LDH (71%)
- Elevated WBC (56%)
Differential Diagnosis
- Gastritis/gastric ulcer
- Herpes Zoster
- Pancreatitis
- Splenic rupture/distension
- Splenic Infarction
- Myocardial Ischemia
- Pneumonia
- Pulmonary Embolism
Workup
- Abdominal CTA
Management
- Treat underlying cause
- Simple cases may require only pain medication
- Complicated cases may require surgical intervention
Disposition
Depends on underlying cause
See Also
References
- ↑ 48.Lawrence YR, Pokroy R, Berlowitz D, et al. Splenic infarction: an update on William Osler's observations. Isr Med Assoc J 2010; 12:362.
