Splenic infarction: Difference between revisions
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*Hypercoagulable state | *Hypercoagulable state | ||
**Malignancy | **Malignancy | ||
**Antiphospholipid | **[[Antiphospholipid syndrome]] | ||
*Embolic disease | *Embolic disease | ||
**[[Atrial Fibrillation]] | **[[Atrial Fibrillation]] | ||
**Patent foramen ovale | **[[Patent foramen ovale]] | ||
**Atheromatous disease | **Atheromatous disease | ||
**Infective [[endocarditis]] | **Infective [[endocarditis]] | ||
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*Any splenomegaly | *Any splenomegaly | ||
**Gaucher disease | **Gaucher disease | ||
**Splenic lymphoma | **Splenic [[lymphoma]] | ||
*[[Splenic Trauma]] | *[[Splenic Trauma]] | ||
*Splenic arterial torsion | *Splenic arterial torsion | ||
| Line 30: | Line 30: | ||
*Splenomegaly (32%) | *Splenomegaly (32%) | ||
*Elevated LDH (71%) | *Elevated LDH (71%) | ||
*Elevated WBC (56%) | *[[leukocytosis|Elevated WBC]] (56%) | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Management== | ==Management== | ||
*Treat underlying cause | *Treat underlying cause | ||
**Simple cases may require only pain medication | **Simple cases may require only [[analgesia|pain medication]] | ||
**Complicated cases may require surgical intervention | **Complicated cases may require surgical intervention | ||
Latest revision as of 04:11, 30 September 2019
Background
- Occlusion (clot or infection) of splenic artery or one or more of its sub-branches
Causes
- Hypercoagulable state
- Malignancy
- Antiphospholipid syndrome
- Embolic disease
- Atrial Fibrillation
- Patent foramen ovale
- Atheromatous disease
- Infective endocarditis
- Myeloproliferative disorders 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
- Gastritis/gastric ulcer
- Herpes Zoster
- Pancreatitis
- Splenic rupture/distension
- Splenic Infarction
- Myocardial Ischemia
- Pneumonia
- Pulmonary Embolism
Workup
- Abdominal CTA
Management
- Treat underlying cause
- Simple cases may require only pain medication
- Complicated cases may require surgical intervention
Disposition
- Depends on underlying cause
See Also
References
- ↑ 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.