Spleen infarct secondary to thrombus in COVID-19-related splenic vein: A case report

Dagistanli, Sevinc; Sönmez, Süleyman

doi:10.1016/j.ajg.2021.03.003

Cited by 2 publications

(2 citation statements)

References 11 publications

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“…Infection Cytomegalovirus [6][7][8] Epstein-Barr virus [9][10][11][12][13][14][15] Infective endocarditis [16][17][18][19][20][21][22] COVID-19 [23][24][25][26][27][28][29][30][31][32][33][34][35] Dengue virus [36] Mycoplasma pneumoniae [37,38] Malaria [39,40] Scrub typhus [41,42] Aspergillus pericarditis [43] Babesiosis [44] Malignancy including neoplasm and myeloproliferative diseases…”

Section: Causes Of Splenic Infarction Referencesmentioning

confidence: 99%

Clinical, Hematological, Biochemical and Radiological Characteristics for Patients With Splenic Infarction: Case Series With Literature Review

et al. 2023

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Background Splenic infarction is a frequently missed diagnosis in acute clinical conditions and is often under-diagnosed due to the lack of high-quality evidence on pathophysiology of splenic infarction. Due to the scarcity of such evidence, no consensus guidelines regarding the diagnostic approach and management of patients with splenic infarction exist. Most of published articles on splenic infarction are case reports and there was no systematic review on splenic infarction. Methods We conducted a retrospective analysis of all radiologically confirmed cases of splenic infarction patients with any history of admission at National Center for Global Health and Medicine Kohnodai Hospital, from 2014 to 2020. Further, to understand the pathophysiology that causes splenic infarction, we searched the literatures on splenic infarction. Results We found 18 patients with splenic infarction. The average age was 78 years, and about half of patients had abdominal pain; however, the other half did not have abdominal pain. One-third of patients with splenic infarction died. Leukocytosis with neutrophilia, a decrease of lymphocytes, anemia, hypoalbuminemia, and liver dysfunction were observed. Fibrinogen was decreased and D-dimer was remarkably elevated. Lactate dehydrogenase (LDH) and C-reactive protein (CRP) were remarkably increased. Six patients (33.3%) had cancer, four patients (22.2%) had atrial fibrillation, and four patients (22.2%) had infection. We found 466 case reports on splenic infarction published from 1975 to 2021. Recently, the number of case reports on splenic infarction due to infection, especially, coronavirus disease 2019 (COVID-19), has been remarkably increasing. Furthermore, we found that leukocytosis, a decrease of lymphocytes, elongated activated partial thromboplastin time, decrease of fibrinogen, liver dysfunction, elevation of LDH and blood urea nitrogen can be the prognosis predicting factors for patients with splenic infarction. Conclusion Our study elucidated clinical, hematological, biochemical and radiological characteristics for patients with splenic infarction. We newly found significant differences in blood cell counts, coagulation markers, transaminases, LDH and blood urea nitrogen between patients who died and those who survived, suggesting that these parameters can be the prognosis predicting factors for splenic infarction. Further, our systematic review on case reports about splenic infarction showed the etiology of splenic infarction and the trend of the causative diseases.

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Section: Causes Of Splenic Infarction Referencesmentioning

confidence: 99%

Clinical, Hematological, Biochemical and Radiological Characteristics for Patients With Splenic Infarction: Case Series With Literature Review

et al. 2023

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“…Coronavirus disease-2019 (COVID- 19) is a viral infection caused by a member of the coronavirus family, the severe acute respiratory syndrome coronavirous-2 (SARS-CoV-2) [1,2]. The disease was first reported in China in December 2019; since then, it has spread all over the world, turning into a pandemic, causing millions of deaths and infecting more than five hundreds of millions of people [3][4][5]. The clinical presentation of COVID-19 may range from asymptomatic disease to severe illness, but the virus predominantly attacks the pulmonary system, leading to acute lung injury and diffuse alveolar damage [3].…”

Section: Introductionmentioning

confidence: 99%

Splenic Artery Infarct Requiring Surgery: A Rare Complication of COVID-19 Infection

Dimitriou

Christodoulou

Chatzimargaritis

et al. 2022

Case Reports in Surgery

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Introduction. Coronavirus disease (COVID-19) from SARS-CoV-2 infection is linked to a hypercoagulable state, leading to arterial and venous thrombotic events, of which pulmonary embolism is the most frequent. However, arterial thromboembolisms may also occur as visceral infracts in unusual sites, such as the renal, splenic, and intestinal arteries. Case Report. A 46-year-old unvaccinated male with a COVID-19 infection was admitted to the COVID-19 isolation ward with symptoms of respiratory infection. He complained of epigastric pain and fever for several days; radiological imaging of the abdomen revealed complete splenic arterial occlusion due to a large infarct. He was treated with low molecular weight heparin (enoxaparin) in therapeutic doses, resulting in minimal improvement. However, the pain worsened, and eventually, a laparotomy and splenectomy were performed. He was hospitalized for another 36 days before he was discharged in good condition. A second surgery was performed to remove a noninfected encapsulated hematoma from the subdiaphragmatic space. The patient remained healthy afterward, with no relapses. Discussion. Although rare, the number of cases of visceral infarcts in COVID-19 patients has increased. Splenic artery infarct is an exceptional case of acute abdominal pain that can be treated successfully with anticoagulant medication. Splenectomy may be required to manage refractory pain after failure of conservative management.

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Spleen infarct secondary to thrombus in COVID-19-related splenic vein: A case report

Cited by 2 publications

References 11 publications

Clinical, Hematological, Biochemical and Radiological Characteristics for Patients With Splenic Infarction: Case Series With Literature Review

Clinical, Hematological, Biochemical and Radiological Characteristics for Patients With Splenic Infarction: Case Series With Literature Review

Splenic Artery Infarct Requiring Surgery: A Rare Complication of COVID-19 Infection

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