Clinical spectrum of splenic infarction – a South Indian perspective
DOI:
https://doi.org/10.3823/1997Keywords:
Splenic infarct, abdominal pain, splenomegaly, embolus, abscessAbstract
Background:
Splenic infarction is a rare condition which is presently detected with increasing frequency on imaging studies, but our knowledge about its presentation and etiology is still inadequate. The clinical profile has evolved tremendously since its original description. Case reports with malarial etiology are preponderant in the Indian literature review. The study objective was to identify the prevailing clinical spectrum of splenic infarction in our tertiary care center.
Methods:
Retrospective review of in-patients clinically diagnosed with splenic infarction in our hospital, from June 2013 to May 2015, was conducted. Details regarding age, gender, etiology of the infarct, underlying diseases and diagnostic tests were obtained from the electronic medical database. Imaging studies were analyzed for the infarct pattern and its complications.
Results:
Splenic infarction was identified in 25 patients, constituting 0.015% of hospital admissions. Mean age was 43 years. Male to female ratio was 2.5:1. Abdominal pain was the cardinal symptom in only half the patients. 32% complained of fever. Abdominal tenderness was observed in 24%. 6 patients had splenomegaly. Leukocytosis occurred in 60%. Thromboembolic disorders were the predominant cause, followed by pancreatic disorders. 4 previously healthy patients (16%) were diagnosed with concealed fatal diseases. Single infarcts were noted in 16 (64%) patients, of which wedge shaped (36%) lesions were prevalent. Associated other visceral infarcts were present in 6 (24%) patients. Splenic abscess developed in 3 patients (12%), and one underwent splenectomy.
Conclusion:
The foremost etiology in our center was thromboembolic disorder, in comparison with infectious causes. The mainstay therapy is treatment of the underlying disease.
References
. Guth AA, Pachter HL. Splenic infarct. eMedicine J 2002;3:1-11.
. Sankar SK, Uniyal R, Sonkar GK. Three unusual presentations of Plasmodium vivax malaria. Trop Doct 2011;41:240-1.
. N Nand, H Kumar. Splenic infarct of unknown etiology – a rare presentation. JIMSA 2012;25(4),248.
. Aggarwal HK, Jain D, Kaverappa V, et al. Multiple splenic infarcts in acute Plasmodium vivax malaria: a rare case report. Asian Pac J Trop Med 2013;6:416-8.
. Thabah MM, Kumar M, Ramesh A, et al. A case of vivax malaria with splenic infarction. J Vector Borne Dis 2013;50,74-6.
. Aggarwal V, Nagpal A, Agrawal Y, et al. Plasmodium vivax malaria complicated by splenic infarct. Paediatr Int Child Health 2014;34:63-5.
. Raj SS, Krishnamoorthy A, Jagannati M, Abhilash KP. Splenic infarct due to scrub typhus. J Global Infect Dis 2014;6:86-8.
. Gupta BK, Sharma K, Nayak KC, et al. A case series of splenic inarction during acute malaria in northwest Rajasthan, India. Trans R Soc Trop Med Hyg 2010;104(1):81-3.
. Kumar BG, Shetty MA, Chakrapani. Splenic complications in malaria: A case series. Southeast Asian J Trop Med Public Health 2008;39:791-4.
. Hota PK, Singh KJ. Splenic infarction: an intriguing and important cause of pain abdomen in high altitude. Bali Med J 2015;4(1),1-4.
. Osler W. The Principles and Practice of Medicine. 4th edn. New York: D. Appleton and Company, 1901.
. Ami S, Meital A, Ella K, Abraham K. Acute splenic infarction at an academic general hospital over 10 years. Medicine 2015;94(36):1-6.
. Lawrence YR, Pokray R, Berlowitz D, et al. Splenic Infarction: An Update on William Osler’s Oberservations. IMAJ 2010;12,362-5.
. Waleed albaker, et al. Experience of significant splenic infarction at university hospital; case series. International Journal of Current Research 2013;5(9),2609-2610.
. Gorg C, Seifart U, Gorg K. Acute, complete splenic infarction in cancer patient is associated with fatal outcome. Abdom Imaging 2004;29(2),224-7.
. Antopolsky M, Hiller N, Salameh S, et al. Splenic infarction: 10 years of experience. Am J Emerg Med 2009;27(3):262-5.
. Baclar I,Setlzer SE, Davis S. CT patterns of splenic infarction: A clinical and experimental study. Radiology 1984;151:723-9.
. Jaroch MT, Brougham TA, Hermann RE. The natural history of splenic infarction. Surgery 1986;743-750.
. Nores M, Phillips EH, Morgenstern L. The clinical spectrum of splenic infarction. Am Surg 1998;64(2): 182-8.
Downloads
Published
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access and Benefits of Publishing Open Access).
Â
Â