Fact-sheet: Splenic infarction
Updated on 04/23/2019 at 9:56 AM
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Definition
Ischemic lesion of all or part of the splenic parenchyma, which may be secondary to an embolic cause, vasculitis, low-flow states, Portal hypertension, Acute pancreatitis, or liver disease.
Clinical features
Acute left upper quadrant pain associated with fever
Laboratory findings
Inflammatory syndrome with leukocytosis and elevated CRP
Ultrasound
Triangular hypoechoic lesion with a subcapsular base, more or less heterogeneous
The contours of the Spleen are preserved
Doppler: may demonstrate the arterial or venous occlusion responsible for the infarction
CT
Spleen most often of normal size
Triangular perfusion defect with a subcapsular base, but sometimes rounded, or involving the entire splenic parenchyma
Persistent capsular enhancement after contrast administration
Possible identification of an arterial or venous thrombus responsible for the infarction (direct sign)
Management
Analgesic and etiologic treatment
Differential diagnosis
Splenic abscess: infectious context with lesions that are more often multiple and confluent, which may rarely contain gas bubbles