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Case Report

Case Report of Splenic Infarct with Proximal Splenic Artery and Coeliac Trunk Thrombosis

Gulati D. , Gulati D. , Ramsundar S. , Datta K. , Das I. , Nagarani S. K. S.

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Indian Journal of Emergency Medicine 1(2):p 113-116, Jul-Dec 2015. | DOI:

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Abstract

 A thrombus formation in the splenic artery occludes the vascular supply of the spleen, leading to ischemia of parenchyma of spleen and subsequently necrosis – Splenic Infarct. It is often clinically silent, the most common symptom being Pain Abdomen / LUQ (Left Upper Quadrant) pain and the sign being Left Hypochondrium Tenderness. There are a multitude of causes for splenic artery thrombosis and infarction, ranging from hematological disorders and malignancies to embolic disorders, vasculitis, autoimmune and collagen vascular diseases, trauma, systemic inflammatory disorders etc.  As the presentation tends to mimic other diseases, a high degree of clinical suspicion is warranted for diagnosis. A contrast enhanced CT scan is the current diagnostic modality of choice. Splenic infarction alone is not an indication for surgery. Non-operative medical management requires close follow up and surgery is indicated for persistence of symptoms and/or complications. We are reporting the case of a young male who presented to the emergency with 4 days of low grade fever and nausea with sudden onset severe pain in epigastrium and left hypochondrium. Normal lab investigations and USG abdomen were followed up with a CECT-abdomen that revealed splenic infarction and 90% stenosis of celiac trunk and hepatic artery with proximal splenic artery thrombosis.

Keywords: Splenic Infarct; Splenic Artery Thrombosis; Celiac Trunk Thrombosis.


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