title: [Splenic infarction after warfarin discontinuation during atrial fibrillation].
abstract: We describe a case of patient with splenic infarction, admitted to our department for sudden abdominal pain and fever after discontinuation of anticoagulant therapy for atrial fibrillation, complicating a dilated myocardiopathy and mechanical prosthetic valve. Diagnosis of splenic infarction was made by enhanced-contrast computed tomography, while ultrasounds and radiography were negative. Anticoagulant therapy, gold-standard treatment, was followed by fast clinical improvement. Moreover, splenic infarction should be considered in all cases of acute or chronic pain in left hypochondrium and especially in patients with emboligenous cardiopathies or atrial fibrillation, the most common arrhythmia source of peripheral embolism in clinical practice.
authors.affiliation: UOC di Medicina Interna, Ospedale S Andrea, II Facoltà di Medicina e Chirurgia, Università di Roma Sapienza, Roma, Italia. massimo.trappolini@uniroma1.it
authors.forename: M
authors.initials: M
authors.lastname: Trappolini
authors.forename: A
authors.initials: A
authors.lastname: Scorzai
authors.forename: V
authors.initials: V
authors.lastname: Loguercio
authors.forename: M
authors.initials: M
authors.lastname: Stoppo
authors.forename: A
authors.initials: A
authors.lastname: Sebastianelli
authors.forename: M
authors.initials: M
authors.lastname: Iannotta
authors.forename: F
authors.initials: F
authors.lastname: Del Porto
authors.forename: M
authors.initials: M
authors.lastname: Proietta
authors.forename: G
authors.initials: G
authors.lastname: Aliberti
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D002311:Cardiomyopathy, Dilated / Q000150:complications; D004617:Embolism / Q000517:prevention & control; D004630:Emergencies; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008943:Mitral Valve; D010138:Pacemaker, Artificial; D010349:Patient Compliance; D011183:Postoperative Complications; D013159:Splenic Infarction / Q000139:chemically induced* / Q000175:diagnosis; D013375:Substance Withdrawal Syndrome / Q000209:etiology*; D019851:Thrombophilia / Q000139:chemically induced / Q000209:etiology; D014859:Warfarin / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin