Splenic infarction

Refers to a condition in which oxygen supply to the spleen is int2242upted, leading to partial or complete infarction.

Occurs when the splenic artery or one of its branches are occluded, for example by a blood clot.

Can be asymptomatic.

Typically associated with severe pain in the left upper quadrant of the abdomen, sometimes radiating to the left shoulder.

Fever and chills occur in some cases.

Must be differentiated from other causes of acute abdomen.

An abdominal CT scan is the most commonly used technique to confirm the diagnosis.

Abdominal ultrasound can also make the diagnosis.

No specific treatment.

Treating the underlying disorder and providing adequate pain relief.

Splenectomy is required if complications ensue.

surgical removal predisposes to overwhelming post-splenectomy infections.

Mortality rate about 5%.

Complications include a ruptured spleen, hemorrhage, splenic abscess or pseudocyst formation.

Factors may increase the tendency for clot formation, infectious mononucleosis, cytomegalovirus infection, malaria, babesiosis, inherited clotting disorders thrombophilia, Factor V Leiden, antiphospholipid syndrome, atrial fibrillation, cholesterol emboli, patent foramen ovale, endocarditis, malignancy or metastases, hematological disorders with associated splenomegaly, such as the myeloproliferative disorders, splenomeagly, splenomegaly, Gaucher disease, hemoglobinopathies, or a combination of these factors.

Splenic infarction can also result from a sickle cell crisis in patients with sickle cell anemia.

Repeated splenic infarctions in sickle cell disease lead to a non-function spleen-autosplenectomy.

Any factor that compromises the splenic artery can cause infarction including abdominal trauma, aortic dissection, torsion of the splenic artery, external compression on the artery by a tumor.

Splenic infarction can also be a complication of vascular procedures

Splenic infarction can be due to vasculitis or disseminated intravascular coagulation.

May be associated with drugs that predispose to vasospasm or thrombosis, like vasoconstrictors used to treat esophageal varices, sumatriptan or bevacizumab.

Splenic infarction can be induced for the treatment of such conditions as portal hypertension or splenic injury.

Can also be used prior to splenectomy for the prevention of blood loss.

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