Presentation
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We present a patient with celiac artery thromboembolism resulting in splenic infarction. [synapse.koreamed.org]
Case presentation A 28 year old female presented 9 weeks after the term delivery of a healthy baby with severe abdominal pain, shortness of breath and headaches. [oatext.com]
Splenic Infarct Presenting as Sterile Peritonitis with Peripheral Embolic Phenomena Aijaz Syed, Jean L. [advancesinpd.com]
Typically when symptoms are present it is due to rupture and presents with abdominal pain and haemodynamic instability. [jbsr.be]
Respiratoric
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Aspiration
Aspiring medical students can learn more about the latest developments in their field of interest, while patients can learn about treatment options available for different diseases. [books.google.com]
Percutaneous vascular intervention in acute mesenteric artery occlusion is often successful and may involve a combination of thrombus aspiration, thrombolysis and arterial stenting 5. [radiopaedia.org]
Infectious Complications of Injecting Drugs 2 HIV infection: Acute, AIDS Bloodborne hepatitis: C and B Skin and subcutaneous tissue infections: Abscess, cellulitis Pneumonia: Typical community pathogens, aspiration, Klebsiella pneumoniae, tuberculosis [ahcmedia.com]
Gastrointestinal
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Abdominal Pain
Splenic infarction is a relatively uncommon diagnosis and this clinical presentation can mimic other causes of acute abdominal pain. [synapse.koreamed.org]
Evaluation of patients who present with abdominal pain requires a broad differential approach. [6] [7] [8] Lab evaluation my help rule in other causes of abdominal pain. [ncbi.nlm.nih.gov]
They may become seriously ill and have severe abdominal pain because the superior mesenteric artery supplies a large part of the intestine. [merckmanuals.com]
Furthermore, there was now almost complete resolution of the abdominal pain. [jhoonline.biomedcentral.com]
Answer: LV thrombus with splenic thromboembolism This patient’s presentation of sudden onset of severe abdominal pain with hypodense splenic lesions suggests embolic splenic infarction. [ultrasoundoftheweek.com]
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Left Upper Quadrant Pain
Focal splenic infarction may affect the overlying visceral peritoneum resulting in acute left upper quadrant pain particularly on respiration and movement. Causes of splenic infarction : *Sickle cell anaemia. *Leukaemia. *Bacterial endocardites. [medicalechography.com]
Patients with a splenic infarction may present with left upper quadrant pain. Some may have constitutional symptoms such as fevers and chills while others may even have diffuse abdominal pain 5,9. [radiopaedia.org]
The left upper quadrant pain secondary to splenic capsular distension resolved almost immediately. [oatext.com]
upper quadrant pain (33%) and fever and chills (27%). 8 The most common sign for splenic infarction is left upper quadrant tenderness, seen in 35% of patients. 8 Splenomegaly may be present in up to 10% of patients. [thepermanentejournal.org]
A patient with metastatic angiosarcoma to the spleen with acute abdominal distention and left upper quadrant pain. The CT (not shown) and ultrasound demonstrated an enlarged, heterogeneous spleen with new large abdominal ascites. [evtoday.com]
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Upper Abdominal Pain
A fifty-three-year-old male patient was admitted to our hospital with upper abdominal pain of sudden onset, which continued for 4-days, with complaints of nausea and vomiting. [synapse.koreamed.org]
Cases Patient 1 A 32-year-old diabetic woman on CAPD for 2 years was admitted for cloudy dialysate and left upper abdominal pain. [advancesinpd.com]
Case 2 A 27-year-old nonalcoholic male with sudden onset upper abdominal pain for two days had a sudden unexplained cardiovascular collapse. [jpgmonline.com]
Septic thromboemboli may result in splenic abscesses, which present with sepsis and left upper abdominal pain. [thehealthscience.com]
Postembolization syndrome of fever, left upper abdominal pain, nausea, and anorexia are extremely common after splenic artery embolization. All patients should be given patient-controlled analgesia (PCA) for pain control. [evtoday.com]
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Abdominal Tenderness
Their observations were as follows: Mean age 52 years old 50% complained of localized left sided abdominal pain 36% had left sided abdominal tenderness 32% splenomegaly 31% had no signs or symptoms localized to the spleen area 36% had fever temperature [ncbi.nlm.nih.gov]
Examination may show vague abdominal tenderness disproportionate to the severity of the pain, an abdominal bruit and signs of generalised cardiovascular disease. [patient.info]
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Abdominal Rebound Tenderness
Abdominal rebound tenderness was found on physical examination, especially on the left upper quadrant. [synapse.koreamed.org]
Workup
Routine diagnostic workup of suspected splenic injury includes chest radiographs, abdominal ultrasound, a focused assessment with sonography for trauma (FAST) scan, or CT imaging. [wjes.biomedcentral.com]
X-Ray
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Pneumoperitoneum
Once pneumoperitoneum is established, the splenocolic ligament is usually divided with ultrasonic shears. Next, the lesser sac is entered, and the short gastric vessels are divided. [emedicine.medscape.com]
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Gastric Fistula
Gastric fistula: Due to the intense inflammatory reaction that can accompany splenic abscess, the dissection of the spleen from the greater curve of the stomach can be difficult, and inadvertent unrecognized injuries to the greater curve of the stomach [sc.ehu.es]
Treatment
These treatment methods resulted in successful outcome in these patients. [synapse.koreamed.org]
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Effective PSE may therefore facilitate the delivery of both systemic chemotherapy and locoregional treatment. [evtoday.com]
The successful treatment of RA depends, in part, on its cause. For the purpose of this review, we have divided treatment of RA after liver transplant into 2 categories: treatment for vascular causes and treatment for nonvascular causes. [ectrx.org]
Prognosis
Prognosis The prognosis of splenic infarctions varies enormously, depending on the cause and severity of the disease. [teachmesurgery.com]
Treatment and prognosis Mesenteric arterial or venous occlusion can be treated with anticoagulation or thrombolysis, either systemically or locally. [radiopaedia.org]
Concurrent TACE and PSE for HCC with thrombocytopenia can be expected to help maintain hepatic reserve, and it may contribute to improving the prognosis of HCC. Hence, PSE could lead to an asplenic state. [hrjournal.net]
Etiology
We present an unusual case of splenic infarction in a 53-year-old male without any etiological factors. [synapse.koreamed.org]
Complications Some complications are encountered, more frequently in patients with an embolic etiology. [radiopaedia.org]
The frequency of visualized splenic infarcts may be rising because of the following factors: Etiology There are numerous etiologies of splenic infarct. [thehealthscience.com]
Angiography is indicated when a vascular lesion is suspected as the etiologic cause, as in cases of arterial embolization, or to manage segmental bleeding by embolization. [sc.ehu.es]
In our patient, an OCP-associated prothrombotic state was the probable etiology, and thus short-course anticoagulation therapy was recommended. [thepermanentejournal.org]
Epidemiology
Epidemiology This is chiefly a disease of people aged over 50, although younger people with risk factors for mesenteric venous thrombosis (MVT) - eg, atrial fibrillation (AF) - can be affected. [patient.info]
[…] the cohort. [1] History of the Procedure One of the earliest descriptions of splenic infarct was made in Germany in 1896, after a splenic infarction was seen microscopically following splenectomy for endocarditis (presumably due to septic emboli). [2] Epidemiology [thehealthscience.com]
Epidemiology Splenic infarcts are considered a rare cause of abdominal pain although the exact prevalance is unclear. [ncbi.nlm.nih.gov]
Department of Epidemiology & Preventive Medicine, School of Public Health and Preventive Medicine, Alfred Hospital Monash University Melbourne Australia 7. Melbourne Endovascular Cheltenham Australia 8. [link.springer.com]
Pathophysiology
In all these cases the pathophysiological mechanism is the breakdown of blood supply to the spleen resulting from a lesion of the splenic artery [13-15]. [ispub.com]
A pathophysiologic, gastroenterologic, and radiologic approach to the management of gastric varices. Gastroenterology 126, 1175–1189 (2004). 3. Takahiro, S. et al. [nature.com]
Pathophysiology of septic emboli When discussing the pathophysiology of emboli of cardiac origin, one must consider both non-infective (Libman-Sacks or autoimmune, Marantic or related to wasting illnesses such as cancer) and infective (e.g., bacterial [intechopen.com]
A splenic infarct is caused by occlusion of the splenic artery or one of its branches, resulting in tissue necrosis, and is caused by many separate pathophysiological processes. [teachmesurgery.com]
In the event acute gastrovariceal bleeding, PSE with balloon retrograde transvenous obliteration (BRTO) has been reported. [11] Pathophysiologically, PSE unmasks the protective effect of reduction of portal flow and rise in platelet count; thus, yielding [saudijgastro.com]
Prevention
Therapeutic introduction of various substances into the circulation to occlude vessels, either to arrest or prevent hemorrhaging or to devitalize a structure or organ by occluding its blood supply. Synonym(s): embolisation. [medical-dictionary.thefreedictionary.com]
To prevent refluxof embolic material in THAE. the amount of the embolic material should be adjusted according to the vascular flow volume of the liver. [synapse.koreamed.org]
Prevention of variceal rebleeding. Lancet 2003;361:952-4. 3. Madoff DC, Denys A, Wallace MJ, Murthy R, Gupta S, Pillsbury EP, et al. Splenic Arterial Interventions: Anatomy, Indications, Technical Considerations and Potential Complications. [saudijgastro.com]
Prevention (Venous) The best prevention is to reverse your risk factors in regard to lifestyle changes. Do not smoke. Develop an exercise program and healthy diet to control your weight. [vascularcenterwf.com]