Acute Splenic Infarction at an Academic General Hospital Over 10 Years

Schattner, Ami; Adi, Meital; Kitroser, Ella; Klepfish, Abraham

doi:10.1097/md.0000000000001363

Cited by 64 publications

(95 citation statements)

References 18 publications

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“…With the use of contrast materials that are compatible with USG, diagnosis is achieved at high rates (9). Contrast-enhanced CT is a highly useful diagnostic tool for spleen infarction and is the preferred radiological diagnostic method in clinical practice (8,10). With contrast In accordance with the literature, majority of our patients were diagnosed with USG (81%) and all patients were diagnosed with CT, and abscess formation was also identified.…”

Section: Discussionsupporting

confidence: 75%

Invasive Management of Abscess Due to Splenic Infarct: A Retrospective Analysis of Thirteen Cases

Karabacak¹,

Tamam²,

Balas³

et al. 2019

Haseki

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Splenic infarction is a rare condition successfully treated with medical methods in general. The aim of this study was to evaluate the invasive treatment options in patients with splenic infarction-associated abscess. Methods: Files of thirteen patients, who underwent percutaneous drainage or a surgical procedure due to abscess as a result of splenic infarction, were retrospectively reviewed. Age symptoms, results of physical and radiological examinations and therapeutic methods were analyzed. Results: A total of 13 patients with the mean age of 56±18 years were included in the study. Seven (54%) patients were female and six (46%) were male. Acute abdomen was observed in 11 patients (85%), and acute abdomen as well as high white blood cell (WBC) count (>15000/mL) in nine patients (70%). Percutaneous drainage was performed in five patients (39%) and splenectomy in eight patients (62%), all of whom were diagnosed with splenic abscess by means of computed tomography. There was no difference in age, gender, acute abdomen, WBC count, platelet count and mortality between patients who underwent splenectomy and percutaneous drainage group, whereas in the splenectomy group, the number of associated diseases was higher and the length of hospital stay was longer (p=0.017 and p=0.011, respectively). Conclusion: Percutaneous drainage and, when necessary, splenectomy should be performed in patients who develop abscess as a result of splenic infarct, whose general health conditions deteriorates and whose symptoms do not improve and who have high WBC count despite medical treatment.

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Section: Discussionsupporting

confidence: 75%

Invasive Management of Abscess Due to Splenic Infarct: A Retrospective Analysis of Thirteen Cases

Karabacak¹,

Tamam²,

Balas³

et al. 2019

Haseki

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“…Splenic infarction is a rare event, accounting for only 0.016% of admissions at a single academic medical center over 10 years. 49 The presentation is variable; however, the most common clinical and laboratory features include left-sided abdominal pain (33%), nausea and vomiting (22%), fever and chills (27%), increased LDH (69%), and leukocytosis (58%) according to a study of 49 patients at a single emergency department. 50 Splenic infarction can occur in a variety of settings as evidenced by case series and reports, but the main causes include embolic, hypercoagulable states, hematologic disease associated with splenomegaly, infection, and cryptogenic.…”

Section: S Pleni C Infarc Ti Onmentioning

confidence: 99%

“…Cardiogenic emboli were the predominant etiology in two case series. 49,51 Atrial fibrillation was common in these groups, although septic emboli from infective endocarditis remains a noteworthy source of infarction. 52 The most commonly cited hypercoagulable state associated with splenic infarction was antiphospholipid antibody syndrome, especially in younger patients.…”

Section: S Pleni C Infarc Ti Onmentioning

confidence: 99%

“…52 The most commonly cited hypercoagulable state associated with splenic infarction was antiphospholipid antibody syndrome, especially in younger patients. 49,50,53 Hematologic diseases including myeloproliferative neoplasms such as polycythemia vera, 54 chronic myelogenous leukemia, 55 Small, repetitive splenic infarcts are common in patients with sicklecell anemia and have been documented in those with sickle-cell trait. 56 In addition to hemoglobinopathies directly causing splenic infarction, they have also been shown to indirectly predispose patients infected with Epstein Barr virus to infarction due to the congestion associated with acute splenic enlargement.…”

Section: S Pleni C Infarc Ti Onmentioning

confidence: 99%

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Arterial thrombosis in unusual sites: A practical review

O’Donnell

Shatzel

Olson

et al. 2018

European J of Haematology

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While common forms of arterial disease such as stroke and myocardial infarction are well studied and appropriate treatment algorithms are well described, occasionally, practitioners will encounter patients with thrombosis in other arteries; the cause and treatment of which is not entirely obvious or well studied. In this section, we will review the current data on arterial thrombosis, describing anatomic sources and hypercoagulable associations, and outline the epidemiology, pathophysiology, clinical presentation, etiology, and treatment of intracardiac thrombus, primary aortic mural thrombus, visceral infarctions, and cryptogenic limb ischemia. (Table 1). | ARTERIAL THROMBOS IS-ANATOMIC CONS IDER ATIONSArterial thrombosis most often occurs in association with atherosclerosis. In cryptogenic cases, arterial thrombosis may result from an anatomic source, the most common of which is cardioembolic, such as intracardiac thrombus, atrial appendage thrombus, patent foramen ovale with paradoxical embolus, and valvular vegetation.The minimal workup we consider in truly cryptogenic cases is assessment for a cardioembolic source ( Figure 1) including a transthoracic echocardiogram in conjunction with injection of agitated saline contrast and color Doppler imaging in order to detect a patent foramen ovale. Due to the unique nature of intracardiac thrombi and primary aortic mural thrombi, the following sections will outline the epidemiology, etiology, and management of these entities. | INTR AC ARD IAC THROMB ILeft ventricular (LV) thrombus most commonly occur after myocar- K E Y W O R D Sarterial thrombosis, coagulation disorder, hypercoagulable, infarction

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“…The abdominal computed tomography (CT) with contrast medium can demonstrate signs of vascular thrombosis and a loss of parenchymal vascular signal. 1 We observed a 57-year-old woman admitted to our Intensive Care Unit (ICU) for pneumococcal septic shock with disseminated intravascular coagulation and purpura fulminans. 2 During the hospitalization, she underwent an abdominal echo-Doppler with contrast agent that revealed a complete loss of splenic perfusion which suggested a MSI (Figure 1).…”

Section: Imaging In Internal Medicinementioning

confidence: 99%

Massive splenic infarction in a patient with pneumococcal septic shock and unknown celiac disease

et al. 2017

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Splenic infarction (SI) is a rare event occurring when the splenic artery or its branches become occluded by embolus or by in situ thrombosis. Many SI events are a result of embolic sources either cardiac or aortic. Massive splenic infarction (MSI) results from compromised blood flow to more than half of the spleen. In this paper we describe a case of a previously healthy patient who presented with pneumococcal sepsis who, upon investigation, revealed an unknown celiac disease and a MSI. Abdominal ultrasound with contrast agent was a useful tool for a diagnosis and follow up of this patient.

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Acute Splenic Infarction at an Academic General Hospital Over 10 Years

Abstract: Supplemental Digital Content is available in the text

Cited by 64 publications

References 18 publications

Invasive Management of Abscess Due to Splenic Infarct: A Retrospective Analysis of Thirteen Cases

Invasive Management of Abscess Due to Splenic Infarct: A Retrospective Analysis of Thirteen Cases

Arterial thrombosis in unusual sites: A practical review

Massive splenic infarction in a patient with pneumococcal septic shock and unknown celiac disease

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