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Splenic infarction
Other Resources UpToDate PubMed

Splenic infarction

Contributors: Benjamin L. Mazer MD, MBA
Other Resources UpToDate PubMed

Synopsis

A splenic infarction is an ischemic injury to the spleen. It most commonly presents with severe, sharp pain, with a quarter of patients presenting with classic left upper quadrant pain and about half with pain elsewhere in the abdomen; a significant portion have no abdominal pain. Radiation to the left shoulder may sometimes occur, called a Kehr sign. Leukocytosis and fever may also be present. Infarction may lead to rupture, which can cause life-threatening hemorrhage.

Forty percent of splenic infarction cases have more than one predisposing condition, diseases predisposing to embolus, abdominal inflammation, and sickle cell disease. Patients with sickle cell disease are most likely to develop chronic splenic microinfarcts. By the age of 5, these microinfarcts have usually left a patient with sickle cell disease functionally asplenic.

Treatment is typically supportive, with pain control being the main goal. Resources for opioid prescribing guidelines, as well as nonopioid alternatives, can be found here.

Codes

ICD10CM:
D73.5 – Infarction of spleen

SNOMEDCT:
22996003 – Splenic Infarction

Differential Diagnosis & Pitfalls

Left upper quadrant pain:

Best Tests

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated:09/02/2020
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Splenic infarction
Splenic infarction : Chills, Fever, Flank pain, Vomiting, Pleuritic chest pain, Shoulder pain, Splenomegaly, LUQ pain
Imaging Studies image of Splenic infarction
T2 MRI image of splenic infarct with large subcapsular hematoma.
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