SPLENIC INFARCTION: an intriguing and important cause of pain abdomen in high altitude

Hota, Prasan Kumar; Singh, Kulwant

doi:10.15562/bmj.v4i1.94

Cited by 4 publications

(3 citation statements)

References 9 publications

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“…Altitude levels were reported for 59 individuals [ 9 , 11 , 13 , 17 ‐ 23 , 26 ‐ 28 , 30 , 34 , 37 , 39 , 41 , 43 , 44 , 46 ‐ 48 , 50 ‐ 52 , 55 , 57 , 59 ‐ 61 ]. Of the 59 cases reporting altitude, 2 (3%) cases occurred under 1000 m, 4 (7%) cases occurred between 1001 and 2000 m, 17 (29%) cases occurred between 2001 and 3000 m, 27 (46%) cases occurred between 3001 and 4000 m, 2 (3%) cases occurred above 4000 m, and 7 (12%) cases contained a range or ambiguous altitude levels.…”

Section: Resultsmentioning

confidence: 99%

Splenic infarction in sickle cell trait: A comprehensive systematic review of case studies

Jefferson

Sims

Umeh

et al. 2021

eJHaem

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Sickle cell trait (SCT), a commonly asymptomatic condition, has many associated clinical complications that upon presentation, can be very difficult to attribute to SCT. The effects of SCT on the spleen, for example, are not completely understood, though there have been a number of case reports detailing related complications in diverse populations. Our objective was to perform the first comprehensive case report review of splenic infarction in SCT patients to highlight the relevance of this seemingly rare condition. We conducted an extensive literature search reviewing case reports and case series of acute splenic infarctions from 1970 to 2020. This comprehensive search resulted in 54 articles with a total of 85 individuals. The ages ranged from 7 to 65, 12% were female. Individuals were of African‐American (26%), European (16%), South Asian (13%), Middle Eastern (7%), Latin American (7%), North or East African (4%), Mediterranean (4%), West African (1%), and unknown (22%) origins. Although splenic infarct in SCT patients has been associated with high altitudes, 39% of cases reporting altitude occurred below 3000 m. Among cases where HbS values were recorded, 88% occurred in individuals with HbS levels higher than 35%, suggesting that high HbS values may be a risk factor for splenic infarction. Our findings indicate that splenic infarct occurs across a wide range of demographic populations and environmental settings. While our understanding of SCT evolves, the findings here suggest that future advances in research and healthcare could benefit more from real‐time surveillance and registry initiation for various SCT outcomes such as splenic infarct.

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Section: Resultsmentioning

confidence: 99%

Splenic infarction in sickle cell trait: A comprehensive systematic review of case studies

Jefferson

Sims

Umeh

et al. 2021

eJHaem

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“…This report highlights the fact that underlying dormant hemolytic condition should be suspected in an otherwise normal individual experiencing symptoms, signs of vasoocclusive crisis (in this case -splenic infarct) under hypoxic conditions such as in high altitude ascent [5,10].…”

Section: Discussionmentioning

confidence: 72%

A Case of High Altitude Related Splenic Infarct in a Previously Undiagnosed Sickle Cell Trait

Patil¹

2017

Austin J Radiol

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Sickle cell trait is the heterozygous disease form of sickle cell anemia which is generally asymptomatic. Manifestations such as vasoocclusive crisis occur when patients are subjected to anoxic / hypoxic situation, identification of which is important for understanding the cause and management. Splenic infarct is such a manifestation. In this case report we highlight the importance of considering underlying hemolytic anemia in patients presenting with vasoocclusive crisis such as splenic infarct at high altitude.

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“…Most of the Indian literature on splenic infarction emerges from case reports emphasizing its presentation as a complication of infections [2][3][4][5][6][7]. A few case series published were limited to malaria and sickle cell trait [8,9,10]. The classical presentation of splenic infarction is left upper abdominal quadrant pain, tenderness and swelling accompanied by a peritoneal friction rub [11].…”

Section: Introductionmentioning

confidence: 99%

Clinical spectrum of splenic infarction – a South Indian perspective

Vijayaraghavan

Thomas

2016

Int Arch Med

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Background: Splenic infarction is a rare condition which is presently detected with increasing frequency on imaging studies, but our knowledge about its presentation and etiology is still inadequate. The clinical profile has evolved tremendously since its original description. Case reports with malarial etiology are preponderant in the Indian literature review. The study objective was to identify the prevailing clinical spectrum of splenic infarction in our tertiary care center. Methods: Retrospective review of in-patients clinically diagnosedwith splenic infarction in our hospital, from June 2013 to May 2015, was conducted. Details regarding age, gender, etiology of the infarct, underlying diseases and diagnostic tests were obtained from the electronic medical database. Imaging studies were analyzed for the infarct pattern and its complications.Results: Splenic infarction was identified in 25 patients, constituting 0.015% of hospital admissions. Mean age was 43 years. Male to female ratio was 2.5:1. Abdominal pain was the cardinal symptom in only half the patients. 32% complained of fever. Abdominal tenderness was observed in 24%. 6 patients had splenomegaly. Leukocytosis occurred in 60%.Thromboembolic disorders were the predominant cause, followed by pancreatic disorders. 4 previously healthy patients (16%) were diagnosed with concealed fatal diseases. Single infarcts were noted in 16 (64%) patients, of which wedge shaped (36%) lesions were prevalent. Associated other visceral infarcts were present in 6 (24%) patients. Splenic abscess developed in 3 patients (12%), and one underwent splenectomy. Conclusion:The foremost etiology in our center was thromboembolic disorder, in comparison with infectious causes. The mainstay therapy is treatment of the underlying disease.

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SPLENIC INFARCTION: an intriguing and important cause of pain abdomen in high altitude

Cited by 4 publications

References 9 publications

Splenic infarction in sickle cell trait: A comprehensive systematic review of case studies

Splenic infarction in sickle cell trait: A comprehensive systematic review of case studies

A Case of High Altitude Related Splenic Infarct in a Previously Undiagnosed Sickle Cell Trait

Clinical spectrum of splenic infarction – a South Indian perspective

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