title: Spontaneous massive splenic infarction in the setting of renal transplant and septic shock: a case report and review of the literature.
abstract: Massive splenic infarction (MSI) is a rare phenomenon that results from compromised blood flow to more than half of the spleen. Causes of MSI include hematological disorders, coagulopathies, infection, and embolization, and, rarely, MSI is spontaneous. The mainstay of treatment is splenectomy. We report the case of a 50-year-old man with a history of renal transplant who presented with diffuse abdominal pain and rapidly developed septic shock. A computed tomographic study (CT scan) of the abdomen demonstrated MSI. The surgical team was consulted for splenectomy but conservative management was maintained and immune function preserved. The patient's clinical condition was resolved over a three-week period. This report demonstrates successful nonoperative management of a spontaneous MSI most likely secondary to hypoperfusion and a hypercoagulable state from both septic shock and renal transplant.
authors.affiliation: DeWitt-Daughtry Family, Department of Surgery, University of Miami Miller School of Medicine and Ryder Trauma Center/Jackson Memorial Hospital, Miami, FL 33136, USA.
authors.forename: Christine L
authors.initials: CL
authors.lastname: Bokman
authors.affiliation: Department of Internal Medicine, University of Miami Miller School of Medicine and Jackson Memorial Hospital, Miami, FL 33136, USA.
authors.forename: Maroun
authors.initials: M
authors.lastname: Sfeir
authors.affiliation: DeWitt-Daughtry Family, Department of Surgery, University of Miami Miller School of Medicine and Ryder Trauma Center/Jackson Memorial Hospital, Miami, FL 33136, USA.
authors.forename: Veer
authors.identifier: 0000-0003-1468-0126
authors.initials: V
authors.lastname: Chahwala
authors.affiliation: DeWitt-Daughtry Family, Department of Surgery, University of Miami Miller School of Medicine and Ryder Trauma Center/Jackson Memorial Hospital, Miami, FL 33136, USA.
authors.forename: Enrique
authors.initials: E
authors.lastname: Ginzburg