Perisplenitis is acute inflammation of the capsule of the spleen and its peritoneal covering.
On this page:
Epidemiology
It is seen uncommonly, usually in young and middle-aged patients, but there is no data on its incidence.
Clinical presentation
Acute left hypochondrial or lower chest pain which may simulate pleuritic pain or an acute abdomen.
Pathology
Acute edematous inflammation of the splenic capsule and peritoneal covering. Recurrent attacks may lead to capsular thickening and calcification. It is usually associated with splenomegaly caused by diseases such as sickle cell disease, thalassemia, bilharzia, malaria, and lymphoma.
Radiographic features
CT imaging reveals a persistent, non-enhancing, circumferential subcapsular thin rim of edematous marginal splenic tissue. CT can aid in identifying complications such as splenic abscess formation. Finally, CT helps to exclude other differential diagnoses with similar clinical presentations like splenic infarcts or rupture.
Treatment and prognosis
Treatment is with anti-inflammatories +/- prophylactic antibiotics in the acute stage. In recurrent perisplenitis, a splenectomy may be considered. A complication of untreated perisplenitis is a splenic abscess.
Differential diagnosis
splenic infarct: usually focal, wedge-shaped and deep in location
splenic abscess: ring enhancing collection
Unable to process the form. Check for errors and try again.