Transient Reduction of Spleen Density in Acute Pancreatitis

Abstract

A healthy spleen has density stable on computed tomographic (CT) scan; in some patients, spleen infarction can be associated with acute pancreatitis. Here, we report 2 patients with acute pancreatitis associated with transient reduction of spleen density that were confirmed in our hospital. The clinical data of the 2 patients were retrospectively analyzed, and the relevant literature was reviewed. Acute pancreatitis with transient reduction of splenic density has certain characteristics in clinical and radiological aspects. After clinical treatment, the spleen density can be restored. Its mechanism may be related to glucose and lipid metabolism, transient thrombosis formation in splenic vessels, and so on.

The diffuse reduction in spleen density: an indicator of severe acute pancreatitis?

“…Because DROSD in AP might be related to high blood lipid levels, we analysed the correlations of TC and TG with spleen density by logistic regression [ 10 ]. As shown in Figure 6 a and b, TC and TG did not differ between the control and reduction groups of patients with AP (4.69 ± 1.95 compared with 5.26 ± 2.88, β = −0.096, P =0.32, P >0.05; 3.82 ± 3.15 comapred with 4.12 ± 4.22, β = −0.019, P =0.723, P >0.05).…”

“…The spleen is an abdominal parenchymal organ of the human body, and a healthy spleen has stable density on CT scans (the CT value is 40–55 HU) [ 10 , 26 ]. However, we recently observed that AP could be associated with DROSD in some patients clinically ( Figure 2 b).…”

“…Additionally, some scholars have speculated that the mechanism of DROSD in AP might be due to high blood lipids, which can result in the deposition of lipids in the internal organs of these patients [ 10 ]. Unfortunately, relevant evidence-based medicine has been lacking.…”

“…Herein, we consulted much of the relevant literature, but only related case reports were found. For example, Arenal et al [ 7 ] reported two cases of AP complicated by splenic infarction; Ray et al [ 8 ] reported a case of SAP in which the patient's spleen was removed due to diffuse splenic infarction; Hernani et al [ 9 ] reported one case of AP complicated by atraumatic splenic rupture; Jiang et al [ 10 ] reported two cases of AP associated with reduction in spleen density, and they proposed that the phenomenon might be related to lipid metabolism. Unfortunately, due to the limitation of sample size, these reports only referred to the phenomenon of splenic injury in AP, but failed to investigate the relevance between the condition of AP and the injury of spleen.…”

Hereditary pancreatitis of 3 Chinese children

“…Also, it has been mentioned that the density of the spleen is reduced by the high lipid concentration during hyperlipidemic acute pancreatitis. [ 24 ] However, the plasma lipid of the patient in Case A was normal. The integrated therapeutic strategy of HP includes pain control, prevention of recurrence, treatment of exocrine (maldigestion) and endocrine (diabetes) dysfunction, management of complications (pseudocysts, etc), and early detection of pancreatic ductal adenocarcinoma.…”