Splenic Infarction
Splenic Artery
Dermatomyositis with splenic and renal infarctions during corticosteroid therapy. (1/41)
A 60-year-old woman was admitted to our hospital with complaints of muscle weakness and erythema on her extremities. Gottron's sign, heliotrope rash, elevation of serum myogenic enzymes, electromyography and magnetic resonance imaging findings established a diagnosis of dermatomyositis (DM). She was treated with 60 mg of daily prednisolone. One week later, she suddenly developed splenic and renal infarctions, which were considered to have resulted from vasculopathy associated with DM. Cyclophosphamide and anticoagulants along with increasing the dosage of corticosteroid were effective. This is the first report describing splenic and renal infarctions in a patient with adult-onset DM. (+info)Thermophilic multidrug-resistant Campylobacter fetus infection with hypersplenism and histiocytic phagocytosis in a patient with acquired immunodeficiency syndrome. (2/41)
We present a case report of a patient who had acquired immunodeficiency syndrome (AIDS) and Campylobacter fetus infection with a number of unusual clinical and microbiological features. The patient had prominent gastrointestinal symptoms, splenic infarction, splenomegaly with hypersplenism, and hemophagocytic histiocytosis in the spleen and lymph nodes; the organism displayed growth on Campy-selective blood agar, thermotolerance, and resistance to quinolones, piperacillin/tazobactam, ceftazidime, and erythromycin. (+info)Acute cytomegalovirus infection complicated by vascular thrombosis: a case report. (3/41)
We present a case report of a previously healthy adult with cytomegalovirus infection that was complicated by extensive mesenteric arterial and venous thrombosis. To our knowledge, this is the first reported case of this syndrome in an immunocompetent individual who had no predisposing risk factors for thrombosis, and it demonstrates the propensity for cytomegalovirus to be involved in vascular disease. (+info)Splenic accumulation of 99mTc-diphosphonate in a patient with sickle cell disease: case report. (4/41)
Splenic accumulation of 99mTc-diphosphonate is shown in the bone scan of a patient with sickle cell disease. This uptake is assumed to result from splenic infarction and subsequent calcification. The conventional liver-spleen scan with 99mTc-sulfur colloid shows no splenic activity, and a radiograph shows calcification in the left upper quadrant of the abdomen in the expected anatomic location of the spleen. (+info)Asian variant of CD5+ intravascular large B-cell lymphoma with splenic infarction. (5/41)
A 57-year-old man was admitted with fever and epigastralgia, and presented with splenomegaly and pancytopenia. A CT scan revealed splenic infarctions. There were no lymphadenopathies, skin lesions, or neurological abnormalities. A splenectomy was performed. Bone marrow involvement with hemophagocytosis was noted. The diagnosis of Asian variant of intravascular diffuse large B-cell lymphoma was based on intravascular and sinusoidal distribution of large CD5+ B cells. The patient died of the disease 11 months after onset. To our knowledge, this is the first report of AIVL that presented with splenic infarction. This distinct lymphoma should be included in the differential diagnosis of splenic infarction. (+info)Splenic infarction following laparoscopic Nissen fundoplication: management strategies. (6/41)
Techniques for mobilizing the greater curve of the stomach during laparoscopic Nissen fundoplication (LNF) include division of the short gastric vessels (SGV). The splenic artery and vein lie directly posterior to the proper plane of dissection. Uncontrolled bleeding during SGV division places the splenic vessels at risk for inadvertent injury or ligation. We report herein on 2 patients referred to our institution who had left upper quadrant pain and radiographic evidence of segmental splenic infarction (SI) that resulted from a peripheral splenic artery branch injury during LNF. Management strategies included a trial of conservative management and splenectomy for persistent symptoms or complications resulting from SI. Intense inflammation and adhesion formation making laparoscopic splenectomy difficult should be anticipated when operating on the infarcted spleen. (+info)Torted and ruptured wandering spleen presenting as a surgical emergency in pregnancy. (7/41)
Wandering spleen (WS) is characterised by incomplete fixation of the spleen to its supporting linorenal and gastrosplenic ligaments. It can predispose to life-threatening complications due to torsion of its vascular pedicle, splenic infarction, portal hypertension, and haemorrhage. A 27-year-old, 36-week prima gravida underwent emergency caesarean section for tachycardia and hypotension. A healthy baby girl was delivered. However, she remained shocked despite aggressive fluid therapy and intraoperatively it was noted that there was significant intraperitoneal bleeding and the on-call surgical team was summoned. Midline laparotomy revealed a lacerated, infarcted, hypermobile spleen found with free intraperitoneal bleeding. The unsalvageable spleen was resected and the patient went on to make an excellent recovery. The aetiology of WS is contentious. With an increased frequency among multiparous females of reproductive age, some suggest the hormonal effects of pregnancy as contributing factors. Clinical presentations range from an asymptomatic abdominal mass to acute abdominal pain with hypovolaemic shock. WS poses a serious threat to life due to thrombosis, bleeding, or infarction. Ultrasound scan and CT scan are equally effective in the diagnosis. Patients with asymptomatic WS should be treated with elective splenopexy, however, in the acute presentation, splenectomy is the procedure of choice. (+info)Splenic syndrome in patients at high altitude with unrecognized sickle cell trait: splenectomy is often unnecessary. (8/41)
BACKGROUND: The health risks associated with sickle cell trait are minimal in this sizable sector of the world's population, and many of these patients have no information about their sickle cell status. Splenic syndrome at high altitude is well known to be associated with sickle cell trait, and unless this complication is kept in mind these patients may be subjected to unnecessary surgery when they present with altitude-induced acute abdomen. METHODS: Four patients were admitted to the surgical ward with a similar complaint of acute severe left upper abdominal pain after arrival to the mountainous resort city of Abha, Saudi Arabia. All were subjected to splenectomy because of lack of suspicion regarding sickle cell status. RESULTS: Histologic examination of the spleen showed all patients had sickle cells in the red pulp. On further assessment all were found to have sickle cell trait with splenic infarction. In a similar study of 6 patients with known sickle cell disease who had comparable problems when they travelled to the Colorado mountains, all made an uncomplicated recovery with conservative management. CONCLUSIONS: In ethnically vulnerable patients with splenic syndrome, sickle cell trait should be ruled out before considering splenectomy. These patients could respond well to supportive management, and splenectomy would be avoided. (+info)Splenic infarction is the death of splenic tissue due to blockage of its arterial supply or, less commonly, its venous drainage. This results in ischemia and necrosis of the affected portion of the spleen. The most common cause is embolism from a distant source such as atrial fibrillation, infective endocarditis, or malignancy. Other causes include splenic artery thrombosis, sickle cell disease, hematologic disorders, and trauma. Clinical presentation can vary widely, ranging from being asymptomatic to acute abdominal pain, nausea, vomiting, and fever. Diagnosis is often made with imaging studies such as ultrasound or CT scan. Treatment depends on the underlying cause and severity of symptoms, but may include anticoagulation, antibiotics, or surgical intervention in severe cases.
The splenic artery is the largest branch of the celiac trunk, which arises from the abdominal aorta. It supplies blood to the spleen and several other organs in the upper left part of the abdomen. The splenic artery divides into several branches that ultimately form a network of capillaries within the spleen. These capillaries converge to form the main venous outflow, the splenic vein, which drains into the hepatic portal vein.
The splenic artery is a vital structure in the human body, and any damage or blockage can lead to serious complications, including splenic infarction (reduced blood flow to the spleen) or splenic rupture (a surgical emergency that can be life-threatening).
A splenectomy is a surgical procedure in which the spleen is removed from the body. The spleen is an organ located in the upper left quadrant of the abdomen, near the stomach and behind the ribs. It plays several important roles in the body, including fighting certain types of infections, removing old or damaged red blood cells from the circulation, and storing platelets and white blood cells.
There are several reasons why a splenectomy may be necessary, including:
* Trauma to the spleen that cannot be repaired
* Certain types of cancer, such as Hodgkin's lymphoma or non-Hodgkin's lymphoma
* Sickle cell disease, which can cause the spleen to enlarge and become damaged
* A ruptured spleen, which can be life-threatening if not treated promptly
* Certain blood disorders, such as idiopathic thrombocytopenic purpura (ITP) or hemolytic anemia
A splenectomy is typically performed under general anesthesia and may be done using open surgery or laparoscopically. After the spleen is removed, the incision(s) are closed with sutures or staples. Recovery time varies depending on the individual and the type of surgery performed, but most people are able to return to their normal activities within a few weeks.
It's important to note that following a splenectomy, individuals may be at increased risk for certain types of infections, so it's recommended that they receive vaccinations to help protect against these infections. They should also seek medical attention promptly if they develop fever, chills, or other signs of infection.
Sickle cell trait is a genetic condition where an individual inherits one abnormal gene for hemoglobin S (HbS) from one parent and one normal gene for hemoglobin A (HbA) from the other parent. Hemoglobin is a protein in red blood cells that carries oxygen throughout the body.
People with sickle cell trait do not have sickle cell disease, but they can pass the abnormal HbS gene on to their children. In certain situations, such as high altitude, low oxygen levels, or intense physical exertion, individuals with sickle cell trait may experience symptoms similar to those of sickle cell disease, such as fatigue, pain, and shortness of breath. However, these symptoms are typically milder and less frequent than in people with sickle cell disease.
It is important for individuals who know they have sickle cell trait to inform their healthcare providers, especially if they become pregnant or plan to engage in activities that may cause low oxygen levels, such as scuba diving or high-altitude climbing.