Splenic infarct - liquefaction

Case contributed by Dr Bruno Di Muzio

Presentation

Nonspecific upper abdominal pain. Lactate elevated on blood tests.

Patient Data

Age: 70-year-old
Gender: Male
CT

CT Abdomen and pelvis (selected images)

On these portal vein images, the spleen shows to be heterogeneously hypoperfused.

Ultrasound

The spleen has heterogeneous echogenicity with an irregular contour in its upper posterolateral aspect with anechoic fluid in between these irregularities and the left diaphragm. A small pleural effusion is also noted on the left. Free fluid within the abdomen.

Case Discussion

This patient had CPK and LDH elevated. CT raised the suspicion for a perfusional disturbance involving the spleen, ultrasound 4 days later demonstrated heterogeneous echogenicity and irregular margins associated with subphrenic fluid. Features that are in keeping with splenic infarct with liquefaction. 

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Case information

rID: 45031
Case created: 12th May 2016
Last edited: 12th May 2016
Inclusion in quiz mode: Excluded

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