Clinical spectrum of splenic infarction – a South Indian perspective
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.
Retrospective review of in-patients clinically diagnosed with 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.
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.
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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