Splenic infarct

Case contributed by Dr Henry Knipe

Presentation

Likely infective endocarditis. Now severe LUQ pain and palpable splenomegaly ?infarct.

Patient Data

Age: 31
Gender: Male
Ultrasound

Upper abdomen

Mild splenomegaly. In the mid-to-upper spleen is a hypoechoic, avascular band extending across the spleen measuring approximately 1cm in width, in keeping with a localised infarct.No free fluid. 

Patient complained of increasing left upper quadrant pain and a CT was organised to asses for an progression of the splenic infarct or a new left kidney infarct. 

CT

Upper abdomen

Wedge-shaped hypodensities through the anteroinferior aspect of the spleen in keeping with splenic infarct. Small amount of perisplenic fat stranding. This has progressed compared to the recent ultrasound.

At the right renal midpole is a small cortical hypodensity. Cholelithiasis. Liver, adrenal glands and left kidney have a normal appearance. Small left pleural effusion and dependent left basal atelectasis.

Case Discussion

Splenic infarction in the setting of infective endocarditis is common, complicating approximately 35% (range 20-47%) of patients with left-sided infective endocarditis. Splenic infarcts themselves can be complicated by splenic abscess formation. 

Unsurprisingly there is also a probable small renal infarct. 

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Case information

rID: 27930
Case created: 27th Feb 2014
Last edited: 29th Sep 2016
Inclusion in quiz mode: Included

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