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Splenic infarction

Case contributed by Brendan Cullinane

Presentation:

55 yo old female with severe left upper abdominal pain radiating across the abdomen and becoming less severe. Of course, the referral was to investigate epigastric/RUQ pain. She did not reveal any risk factors for arterial disease.

Patient Data:

Age: 55
Gender: Female
Race: Caucasian
Modality: Ultrasound

See below

Modality: CT

See below

Case Discussion:

The spleen demonstrated the classic ultrasound appearance of a splenic infarct: a hypoechoic, wedge-shaped defect. There was no evidence of other causes of the left-sided pain such as pancreatitis, inferior mesenteric artery stenosis or urinary tract pathology.

CT confirmed the infarction and CT-A revealed significant disease within branches of the splenic artery.

The patient was referred to the local public hospital where she was counseled regarding total splenectomy. She declined this procedure. I saw her last week, 3 months after these examinations, and she said the pain had disappeared.

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