Left flank pain. WCC 14, CRP 100.
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Wedge-shaped hypodensity within the spleen with mild surrounding fat stranding. Filling defect within a hilar branch of the splenic artery, consistent with thrombus. Proximal splenic artery is not well seen with prominent collateral arteries around the stomach. Trace of pelvic free fluid. No free gas.
Liver, adrenal glands, gallbladder, and pancreas are unremarkable. Bowel is unremarkable. Few small simple renal cortical cysts bilaterally. Prostatomegaly.
Splenic infarcts are an uncommon but well established cause of abdominal pain. In younger patients, haematological causes tend to be more common and in older patients thrombo-embolism is the predominant cause.