Splenic infarction: Difference between revisions
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==Clinical Features<ref>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.</ref>== | ==Clinical Features<ref>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.</ref>== | ||
*Acute LUQ pain (48%) | *Acute [[Abdominal Pain|LUQ pain]] (48%) | ||
**LUQ tenderness (36%) | **LUQ tenderness (36%) | ||
*[[Fever]] (36%) | *[[Fever]] (36%) | ||
Revision as of 21:24, 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
- Atrial Fibrillation
- Patent foramen ovale
- Atheromatous disease
- Infective endocarditis
- 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
- Gastritis/gastric ulcer
- Herpes Zoster
- Pancreatitis
- Splenic rupture/distension
- Splenic Infarction
- Myocardial Ischemia
- Pneumonia
- Pulmonary Embolism
Workup
- Found on 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
Sources
- UpToDate
- ↑ 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.