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Splenic infarction

Case contributed by Brendan Cullinane


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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