Massive Splenic Infarction with Specific Sonographic Feature: Two Case Reports with Rare Etiologies

Zabolinejad, Nona; Alamdaran, Seyed Ali; Farhangi, Hamid; AelamiMH, Mohammad Hasan; Mashhad, Marjan Joodi; Ardestani, Reihaneh Mortazavi

doi:10.23937/2469-584x/1510058

Cited by 2 publications

(2 citation statements)

References 14 publications

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“…Currently, there are limited studies available that attempt to identify the prevalence, etiologies, interventions, and outcomes of splenic infarction in the pediatric population [8]. A massive splenic infarction is described as parenchymal ischemia secondary to vessel occlusion leading to tissue necrosis of at least half of the spleen [9]. For patients below the age of 40 years, etiology is most commonly due to hematologic disease [10].…”

Section: Discussionmentioning

confidence: 99%

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Rare Cause of Abdominal Pain in an Adolescent Patient: Splenic Infarction in Absence of Causative Underlying Hematologic Disorder

Shimshoni¹,

Vandillen²

2020

Cureus

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Splenic infarction is a rare medical condition that usually occurs in the setting of hematologic disorders. It is rarely seen in previously healthy adolescents. A wandering spleen increases the risk of splenic infarct due to risk of torsion and is more commonly seen in pregnancy due to increased elasticity of connective tissue. Wandering spleen may also be associated with diseases, such as Ehlers-Danlos, and should be suspected in the patient with possible underlying connective tissue dysfunction. Although rare, splenic infarction must be on the differential for unremitting upper epigastric pain, fever, and vomiting, particularly when patient medical history suggests connective tissue dysfunction. This case discusses the course of a pediatric patient with abdominal pain with complex medical history found to have splenic infarction secondary to torsion of a wandering spleen initially discovered on emergency CT imaging. Although rarely indicated in pediatric patients with abdominal pain, lower threshold for CT imaging for ruling out emergent etiology resulted in life-saving treatment. This case demonstrates the importance of clinical suspicion for emergency etiology of abdominal pain in pediatric patients with medical history suspicious for connective tissue dysfunction, and therefore lowering the threshold for CT imaging to rule out splenic infarction in these patients.

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Section: Discussionmentioning

confidence: 99%

“…For patients below the age of 40 years, etiology is most commonly due to hematologic disease [10]. Other causes include hypercoagulability, trauma, or enlargement secondary to Epstein-Barr viral infection [2,9,10]. Many times, an underlying abnormality is found during the workup for the initial presentation of a splenic infarction [2].…”

Section: Discussionmentioning

confidence: 99%

Rare Cause of Abdominal Pain in an Adolescent Patient: Splenic Infarction in Absence of Causative Underlying Hematologic Disorder

Shimshoni¹,

Vandillen²

2020

Cureus

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A case report of splenic infarction secondary to atherosclerosis of the splenic artery

Hesam Shariati,

Mohammadi,

Shokrzadeh

2024

Journal of Research in Applied and Basic Medical Sciences

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Massive Splenic Infarction with Specific Sonographic Feature: Two Case Reports with Rare Etiologies

Abstract: We reported two pediatric rare cases with massive splenic infarction that in both of them the interspersed hyperechoic linear striation of the splenic parenchyma was first suggestive sign of infarction, and diagnosis was confirmed by color Doppler and surgery.

Cited by 2 publications

References 14 publications

Rare Cause of Abdominal Pain in an Adolescent Patient: Splenic Infarction in Absence of Causative Underlying Hematologic Disorder

Rare Cause of Abdominal Pain in an Adolescent Patient: Splenic Infarction in Absence of Causative Underlying Hematologic Disorder

A case report of splenic infarction secondary to atherosclerosis of the splenic artery

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