Presentation
A comprehensive textbook of adult emergency medicine for trainee doctors - covers all the problems likely to present to a trainee in the emergency department. [books.google.com]
The most frequent clinical presentation is embolism of the limbs, with a certain predilection for the left arm. 7 This clinical presentation was seen in patient 1 of the present study, although the affected limb was the right arm. [revespcardiol.org]
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]
Entire Body System
- Noncompliance
This may be the result of a variety of factors, such as crowded living conditions, residence in homeless shelters, sharing smoke, and noncompliance with treatment. [ahcmedia.com]
Respiratoric
- Pleural Effusion
effusion and atelectasis (20-50%) 3,4 splenic infarct (~3%) 2 splenic abscess (~2%) 2,3 Promoted articles (advertising) [radiopaedia.org]
He presented with recurrent ascites and a large pleural effusion on his right side and an intrahepatic artery to portal vein fistula. [ectrx.org]
Other complications include pancreatitis, left sided pleural effusion, portal vein thrombosis and splenic abscess [3]. Mortality rate is around 0-6% [1]. [indianpediatrics.net]
effusion on chest x-ray CT Findings • NECT Infarcts may be difficult (or impossible) to visualize without intravenous contrast Areas of hemorrhagic transformation within infarcts appear hyperdense on NECT • CECT Acute findings – Diagnosis best made on [radiologykey.com]
Post-procedure pain and fever were common and manageable; only one patient developed a loculated pleural effusion requiring drainage. [jhoonline.biomedcentral.com]
Gastrointestinal
- 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]
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]
SMA thrombosis presents with gradual onset of abdominal pain and distension. A history of postprandial abdominal pain and weight loss is present in half of cases. [vasculardiseasemanagement.com]
- 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 abdominal pain. [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]
Urogenital
- Renal Insufficiency
Her renal function was normal. Her liver panel showed albumin 2.9 g/dL, total bilirubin 0.6 mg/dL, direct bilirubin 0.2 mg/dL, SGOT 16 U/L, SGPT 4 U/L, alkaline phosphatase 77 U/L. [vasculardiseasemanagement.com]
Collectively, these procedures inherently create a small, but significant risk of IE, especially in patients with chronic comorbid conditions such as renal insufficiency, diabetes and autoimmune diseases [ 129, 130, 131 ]. [intechopen.com]
Major complications including splenic infarction, splenic abscess, contrast-induced renal insufficiency, and splenic cysts occurred in 14 % of the patients who underwent SAE. [wjes.biomedcentral.com]
- Kidney Failure
Other complications of blood clots include stroke, heart attack, kidney problems and kidney failure, and pregnancy-related problems.Treatments for blood clots include blood thinners and other medicines. [icdlist.com]
Rarely, more complete narrowing of one or both renal arteries contributes to the development of kidney failure or high blood pressure (a disorder called renovascular hypertension). [merckmanuals.com]
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
- Gastric Varices
The two-step method was used in 11 patients, who had chronic gastric variceal bleeding or gastric varices only. The gastric varices disappeared in the enhanced CT scan and the patients had no gastric bleeding during follow-up. [ncbi.nlm.nih.gov]
However, there are few cases of red color-positive gastric varices and it is difficult to diagnose a high risk for bleeding of gastric varices. [omicsonline.org]
Gastric variceal hemorrhage, severe portal hypertensive gastropathy, splenic vein thrombosis. Management. Blood transfusion, splenic artery embolization and balloon-occluded retrograde transvenous obliteration of gastric varices. [nature.com]
Note the marked decrease in prominence of the gastric varices. [evtoday.com]
varices in the setting of portal hypertension and gastric variceal bleeding. [6] Hypercoagulable states can cause splenic infarction. [emedicine.medscape.com]
- Atelectasis
[…] malignancy splenic steal syndrome splenic artery aneurysm or pseudoaneurysm There are a multitude of techniques including: partial or complete embolization proximal or distal embolization coil, particle or glue embolization left pleural effusion and atelectasis [radiopaedia.org]
Segmental atelectasis was seen in three patients. Conclusion: Partial splenic artery embolisation is an effective procedure for the control of Hypersplenism. [ijri.org]
[…] nonenhancement when infarct is segmental – Straight margins indicate vascular etiology (rather than a mass or fluid collection) – May very rarely be rounded (atypical appearance) Radiographic Findings • Radiography May be associated with lower left lobe atelectasis [radiologykey.com]
The middle or lower pole splenic branches are usually subselected due to lower risk of pulmonary complications such as atelectasis, pneumonia and pleural effusion, or pain, which are more common with upper lobe embolization. 10 We use Embospheres (Merit [evtoday.com]
Left lower lobe atelectasis, subphrenic abscess formation, showing as a left pleural effusion, or postoperative thrombocytosis are possible complications. [mdmag.com]
- Pleural Effusion on Chest X-Ray
effusion on chest x-ray CT Findings • NECT Infarcts may be difficult (or impossible) to visualize without intravenous contrast Areas of hemorrhagic transformation within infarcts appear hyperdense on NECT • CECT Acute findings – Diagnosis best made on [radiologykey.com]
Pleura
- Pleural Effusion
effusion and atelectasis (20-50%) 3,4 splenic infarct (~3%) 2 splenic abscess (~2%) 2,3 Promoted articles (advertising) [radiopaedia.org]
He presented with recurrent ascites and a large pleural effusion on his right side and an intrahepatic artery to portal vein fistula. [ectrx.org]
Other complications include pancreatitis, left sided pleural effusion, portal vein thrombosis and splenic abscess [3]. Mortality rate is around 0-6% [1]. [indianpediatrics.net]
effusion on chest x-ray CT Findings • NECT Infarcts may be difficult (or impossible) to visualize without intravenous contrast Areas of hemorrhagic transformation within infarcts appear hyperdense on NECT • CECT Acute findings – Diagnosis best made on [radiologykey.com]
Post-procedure pain and fever were common and manageable; only one patient developed a loculated pleural effusion requiring drainage. [jhoonline.biomedcentral.com]
Biopsy
- Hepatocellular Carcinoma
Hepatocellular carcinoma: clinical frontiers and perspectives. Gut 2014;63:844-55. DOI PubMed PMC 3. [hrjournal.net]
Splenic infarction occurred in 5 cases as a complication of 220 procedures of in 70 patients of hepatocellular carcinoma. [synapse.koreamed.org]
[…] embolization, Extremity angiography, Feeding tube insertion - gastrostomy, Gastrointestinal bleeding, Hemangioma, Hemodialysis Access, Hepatic hemangioma, Hepatic ischemia, Hepatic vein obstruction (Budd-Chiari), Kidney biopsy, Liver biopsy, Liver cancer - Hepatocellular [m.ufhealth.org]
Treatment
Thrombocytopenia has been improved and treatment continued using concurrent PSE. In addition, hepatic functional reserve could be maintained even after treatment for HCC. [hrjournal.net]
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]
Possible Complications of Endovascular Treatment The occurrence of complications after endovascular treatment is uncommon. [pubs.rsna.org]
[…] may be the preferred treatment method for distal aneurysms. [mdmag.com]
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]
In our patient, an OCP-associated prothrombotic state was the probable etiology, and thus short-course anticoagulation therapy was recommended. [thepermanentejournal.org]
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]
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]
The pathophysiology of aortic thrombi is not well -defined. [revespcardiol.org]
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 (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]
Technically, successful embolization requires the catheter be placed in a precise position to prevent injuring normal tissue. [radiologyinfo.org]