The splenic enlargement and a wedge shaped infarct is confirmed. A rounded low density lesion in the adrenal gland on the right is noted, which in retrospect is visible on the noncontrast scans and has, on those scans, a density measurement of 5 HU, consistent with an incidental adrenal adenoma.
The liver is at the upper limit of normal in size and her main portal vein is enlarged measuring 17 mm in diameter. The splenic vein is also enlarged. Focal fatty change is again demonstrated. No focal lesions. The remainder of the upper abdominal solid viscera are unremarkable, with no other infarcts identified. No lymph node enlargement and no focal osseous lesion.
Conclusion
Splenic infarcts is confirmed and presumably accounts of the patient's presentation. The cause of the patient's splenomegaly is uncertain, although the main portal vein and splenic vein do appear enlarged as does the liver raising the possibility of portal hypertension. Incidental adrenal adenoma.