Presentation
Left upper quadrant pain. Known case of right-sided heart disease with aortic valve replacement 30 years ago.
Patient Data
Dilatation of the right atrium, IVC and hepatic veins with contrast reflux from the right atrium into IVC and hepatic veins and heterogeneous, mottled and reticulated mosaic parenchymal enhancement suggestive of passive hepatic congestion.
Multiple peripheral, wedge-shaped hypodense non-enhancing lesions of the spleen with normal intervening enhancing splenic tissue suggestive of splenic infarcts.
The splenic artery and vein are patent.
Scarring in the renal cortex of both kidneys.
Case Discussion
CT features of multiple splenic infarcts in a patient known for right-sided heart failure with passive hepatic congestion as well as aortic valve replacement.
Considering the patient's age and clinical history, the etiology of the splenic infarcts in this case, is probably an embolic event.