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Clinical features
Asymptomatic, with incidental discovery
from radiologic or postmortem studies
hemorrhagic shock as a result of
subcapsular hematoma with rupture into
the peritoneal cavity.
left upper quadrant pain, fever, and chills.
Additional symptoms include nausea,
vomiting, pleuritic chest pain, and left
shoulder pain
Treatment
The mainstay of treatment for splenic
infarction, in the absence of complications,
is analgesia and observation. The arterial
supply to the spleen via the splenic artery
and the short gastric arteries (from the left
gastroepiploic) allow sufficient collateral
flow to preserve much of the spleen
parenchyma with minimal intervention, even
in the event of splenic artery occlusion.
Splenic abscess
Splenic abscesses occur most commonly in
patients with underlying disorders such as
infection, embolic disease, traumatic injury,
malignant hematologic conditions, or
immunosuppression. Solitary abscesses
usually represent localized disease. Overall,
the clinician will most often (70%)
encounter patients with solitary abscesses
Treatment
Splenectomy
4- to reduce anemia or
thrombocytopenia in spherocytosis,
ITP or hypersplenism;
5- in association with shunt or
variceal surgery for portal
hypertension.
Complications
- Hemorrhage, if a ligature slips off the
splenic artery.
- Gastric dilatation following partial
mobilisation of the stomach when
ligating the short gastric vessels.
- Hematemesis may rarely occur possibly due to mucosal damage to the
stomach when ligating the short gastric
vessels.