Splenic infarction: report of three cases of atherosclerotic embolization originating in the aorta and retrospective study of 64 cases.
The authors report 3 cases of thromboembolic splenic infarction due to atherosclerosis of the thoracic aorta and the splenic artery. On this occasion, a retrospective analysis of 64 splenic infarcts showed that, in contrast to the literature, the leading aetiology in our series consisted of haematologic disorders (50%), followed by cardiovascular diseases (29%) and by digestive disorders (20%). Mean age was 58 +/- 17 years and 50% of the patients were aged below 60 years. Hospital mortality rate was high (34%) but not directly related to splenic infarction, suggesting that splenic infarction often occurs in the setting of severe underlying diseases. Splenic infarct is part of the differential diagnosis of the left upper quadrant pain and can also mimic renal disorders. Laboratory values may show an inflammatory syndrome and an increase in serum lactate deshydrogenase. Diagnosis is often made by CT scan and can be confirmed by a selective spleen scintigraphy. Transoesophageal echocardiography is essential in the detection of cardiac and thoracic aorta embolic material.
Frippiat
F
F
Service de Médecine Interne Générale et Endocrinologie, Cliniques de Mont-Godinne, Bruxelles.
Donckier
J
J
Vandenbossche
P
P
Stoffel
M
M
Boland
B
B
Lambert
M
M
D000368:Aged; D001013:Aorta, Thoracic; D001018:Aortic Diseases / Q000150:complications*; D001161:Arteriosclerosis / Q000150:complications*; D015897:Comorbidity; D003952:Diagnostic Imaging; D004617:Embolism / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013157:Splenic Artery; D013159:Splenic Infarction / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality