Splenic infarction: Difference between revisions

Line 33: Line 33:


==Differential Diagnosis==
==Differential Diagnosis==
{{Template:LUQ DDX}}


==Workup==
==Workup==

Revision as of 21:23, 26 March 2014

Background

  • Occlusion (clot or infection) of splenic artery or one or more of its sub-branches

Causes

  • Hypercoagulable state
    • Malignancy
    • Antiphospholipid syndrome)
  • Embolic disease
  • Myeloproliferative neoplasm 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

  1. Gastritis/gastric ulcer
  2. Herpes Zoster
  3. Pancreatitis
  4. Splenic rupture/distension
  5. Splenic Infarction
  6. Myocardial Ischemia
  7. Pneumonia
  8. Pulmonary Embolism

Workup

Management

  • Treat underlying cause
    • Simple cases may require only pain medication
    • Complicated cases may require surgical intervention

Disposition

Depends on underlying cause

See Also

Sources

  • UpToDate
  1. 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.