• Wandering spleen (splenoptosis) predisposes the spleen to complications such as torsion, splenic infarction, pancreatic necrosis and rarely pseudocyst formation. (wikipedia.org)
  • Splenic infarction refers to occlusion of the splenic vascular supply, leading to parenchymal ischemia and subsequent tissue necrosis. (medscape.com)
  • Splenic infarction alone is not an indication for surgery. (medscape.com)
  • As laparoscopic techniques become more advanced, many of the surgical problems associated with splenic infarction certainly will prove amenable to laparoscopic splenectomy or partial splenectomy. (medscape.com)
  • Most commonly, these infarcts contract and fibrose over time, as demonstrated by the sickle hemoglobinopathies (in which repeated episodes of infarction ultimately result in autoinfarction of the spleen). (medscape.com)
  • For instance, the mechanism of splenic infarction in sickle cell disease is attributed to crystallization of the abnormal hemoglobin during periods of hypoxia or acidosis. (medscape.com)
  • In individuals who are heterozygous for sickle trait, exposure to low-oxygen tension (eg, during unpressurized airplane travel) or vigorous activity (eg, skiing in high-altitude locations) can precipitate sickling and splenic infarction by the above-described mechanism. (medscape.com)
  • In malignant hematologic diseases (eg, chronic myeloid leukemia), increased splenic oxygen requirements secondary to an increased splenic mass, coupled with a decreased oxygen-carrying capacity secondary to the anemia of hypersplenism, lead to infarction. (medscape.com)
  • [ 5 , 1 ] Splenic embolization may result from various cardiovascular conditions, including a left atrial or ventricular mural thrombus that formed as a result of acute myocardial infarction or atrial fibrillation or developed from complications of cardiac catheterization or bacterial endocarditis. (medscape.com)
  • Hypercoagulable states can cause splenic infarction. (medscape.com)
  • For instance, hereditary protein C deficiency has been reported to cause splenic infarction. (medscape.com)
  • Splenic vein thrombosis, most commonly the result of pancreatitis or surgery, can result in venous infarction. (medscape.com)
  • Splenic infarction resulting from systemic disorders (see the image below), such as hemoglobinopathies (especially sickle cell disease), leukemia, polycythemia, or vasculitis, can become infected and evolve into splenic abscesses. (medscape.com)
  • Splenic infarction is a result of ischemia to the spleen , and in many cases requires no treatment. (radiopaedia.org)
  • Patients with a splenic infarction may present with left upper quadrant pain. (radiopaedia.org)
  • It should be noted that ~40% (range 30-50%) of patients with splenic infarction are asymptomatic 9 . (radiopaedia.org)
  • The appearance of splenic infarction depends on the timing of imaging and the size of the infarct. (radiopaedia.org)
  • Published studies suggest that preexisting splenic tissue injury and bacteremia are required to form a basis for an abscess. (medscape.com)
  • The arterial supply to the spleen consists of the splenic artery (a branch of the celiac axis) and the short gastric arteries (branches of the left gastroepiploic artery), which supply the upper pole of the spleen. (medscape.com)
  • Even with occlusion of the main splenic artery, collateral flow from the short gastric arteries often may preserve some or all of the splenic parenchyma. (medscape.com)
  • Selective splenic arteriogram showing extravasation of contrast from the splenic artery at the splenic hilum prior to angioembolization. (medscape.com)
  • A 69-year-old woman, a long-term survivor of subtotal stomach-preserving pancreatoduodenectomy with the splenic vein resection for pancreatic cancer, visited our hospital with a chief complaint of bloody stools. (bvsalud.org)
  • However, with the trend of improving the prognosis for patients with pancreatic cancer, we should occasionally pay attention to the development of ectopic varices including colonic varices in patients who have undergone pancreatoduodenectomy with superior mesenteric and splenic veins resection. (bvsalud.org)
  • It is usually found around the splenic hilum or ligaments, pancreatic tail, or sometimes in the pancreatic parenchyma [ 7 ]. (e-ultrasonography.org)
  • Intrapancreatic accessory spleen (IPAS) may mimic pancreatic neoplasms, but requires no further treatment. (e-ultrasonography.org)
  • 2, 3] For example, the incidence of splenic abscesses in Denmark was 0.056% per 1000 somatic hospital discharges per year or 0.0049% per year of all hospital deaths. (medscape.com)
  • As technologies evolve, laparoscopic splenic preservation may become the future standard of care for segmental infarcts. (medscape.com)
  • In homozygous sickle cell disease, multiple infarcts during childhood commonly result in a scarred, contracted, autoinfarcted spleen by adulthood. (medscape.com)
  • Thromboembolism is another common cause of splenic infarcts. (medscape.com)
  • Hematogenous spread in the presence of previously altered splenic architecture - This group includes patients with single splenic infarcts (from trauma) or multiple splenic infarcts (from sickle cell disease or vasculitis). (medscape.com)
  • Splenic infarcts can occur due to a number of processes, involving either arterial supply, the spleen itself or the venous drainage. (radiopaedia.org)
  • Typically infarcts are hypoechoic compared to the rest of the spleen, although acutely they can be isoechoic and hard to identify. (radiopaedia.org)
  • multiple infarcts appear as hypodense non-enhancing lesions, with normal intervening enhancing splenic tissue. (radiopaedia.org)
  • Infective endocarditis, a condition associated with systemic embolization in 22-50% of cases, has a 10-20% incidence of associated splenic abscess. (medscape.com)
  • Hematogenous embolization to a previously normal spleen - Typical examples include patients with septic endocarditis who have abused IV drugs and patients undergoing chemotherapy who develop fungemia, resulting in a splenic abscess. (medscape.com)
  • Morphologically the typical infarct is of a pyramidal wedge of affected splenic tissue with the apex pointing towards the hilum, and the base on the splenic capsule. (radiopaedia.org)
  • If liquefaction occurs, the area may be rounded and anechoic ( splenic pseudocyst ). (radiopaedia.org)
  • Accessory spleen, which results from a failure of the embryonic splenic anlage to fuse and extreme lobulation that separates splenic tissue, is a normal variant observed in 10%-30% of individuals [ 7 ]. (e-ultrasonography.org)
  • BACKGROUND: Left-sided portal hypertension including gastric venous congestion may be caused by ligating the splenic vein during pancreaticoduodenectomy with portal vein resection or total pancreatectomy. (bvsalud.org)
  • Blocking of the arteries and torsion (twisting that interrupts the blood supply to that organ) in the spleen can also result in abdominal pain or swelling. (wikipedia.org)
  • In 1992, the youngest case of the literature of torsion of wandering spleen at two days of birth was reported in Lebanon, by Dr Edouard Sayad. (wikipedia.org)
  • Wandering Spleen: A Challenging Diagnosis" (PDF). (wikipedia.org)
  • Its noninvasiveness, extensive range of application, and low cost make US a useful and valuable tool for the detection, diagnosis, and follow-up of splenic abnormalities. (e-ultrasonography.org)
  • Concomitantly with the increasing frequency of imaging, more splenic lesions are being discovered and the requirements for the differential diagnosis are rising. (e-ultrasonography.org)
  • Knowledge of the US features of various splenic lesions will help narrow the differential diagnosis and guide clinical decision-making. (e-ultrasonography.org)
  • Ultrasonography is a useful and valuable tool for the detection, diagnosis, and follow-up of splenic abnormalities. (e-ultrasonography.org)
  • However, with the increasing frequency of imaging and advances in imaging technology, more incidental splenic lesions are being discovered and the subsequent requirements for the differential diagnosis are growing. (e-ultrasonography.org)
  • The history and physical examination are not sufficiently reliable to make the diagnosis of splenic abscess. (medscape.com)
  • In this pictorial essay, we introduce the representative US findings of many different splenic lesions, including normal sonographic findings, normal variants and congenital anomalies, infectious conditions, benign and malignant neoplasms, and non-neoplastic lesions. (e-ultrasonography.org)
  • Therefore, this pictorial essay elucidates the US findings of various splenic lesions, in correlation with computed tomography (CT) or magnetic resonance (MR) imaging and pathology. (e-ultrasonography.org)
  • The usefulness of reconstruction with the splenic vein has been reported in such cases. (bvsalud.org)
  • However, depending on the site of the tumor and other factors, it may be impossible to leave sufficient length of the splenic vein, making anastomosis difficult. (bvsalud.org)
  • The root of the splenic vein was infiltrated by the tumor, and we resected this vein at the confluence of the portal vein. (bvsalud.org)
  • Closure of the portal vein was performed without reconstruction of the splenic vein. (bvsalud.org)
  • The splenic vein-superior mesenteric vein confluence was infiltrated by the tumor, and we resected the portal vein, including the confluence. (bvsalud.org)
  • End-to-end anastomosis was performed without reconstruction of the splenic vein. (bvsalud.org)
  • The spleen, sometimes called "the forgotten organ" of the abdomen, has received less attention than other abdominal solid organs, as splenic diseases are less common and frequently clinically asymptomatic [ 1 ]. (e-ultrasonography.org)
  • Physical factors may cause ischuria, constipation, as well as numerous spleen-related diseases such as hypersplenism, thrombocytopenia, and lymphoma. (wikipedia.org)
  • Infiltrative hematologic diseases cause congestion of the splenic circulation by abnormal cells. (medscape.com)
  • Therefore, US is widely used and frequently chosen as the first imaging modality for most abdominal imaging, both for general abdominal examinations and for patients suspected of having splenic diseases. (e-ultrasonography.org)
  • However, to the authors' knowledge, there are not enough up-to-date ultrasonographic imaging reviews of splenic diseases [ 2 - 5 ]. (e-ultrasonography.org)
  • Wandering spleen (or pelvic spleen) is a rare medical disease caused by the loss or weakening of the ligaments that help to hold the spleen stationary. (wikipedia.org)
  • Characteristics of the disorder include the loss, weakening, or malformation of the ligaments that help to keep the spleen located in the upper left part of the abdomen. (wikipedia.org)
  • However, lack of visible symptoms - except in incidents of abdominal pain - makes the disease difficult for doctors to diagnose, though medical imaging techniques such as medical ultrasonography, magnetic resonance imaging, or computed tomography can be used to confirm its occurrence. (wikipedia.org)
  • Splenic abscesses occur in a variety of clinical scenarios, as shown in the images below. (medscape.com)
  • Natural history of nonoperative management for grade 4 and 5 liver and spleen injuries in children. (childrensmercy.org)
  • Rarely, splenic abscess can be caused by a parasitic infection such as brucellosis[15] or umbilical catheterization in the newborn. (medscape.com)
  • [ 4 ] In myelofibrosis, the splenic parenchyma is infiltrated by extramedullary hematopoiesis, causing congestion of the splenic circulation. (medscape.com)
  • The usual treatment is splenopexy, fixation of the spleen, but if there is no blood flow after unwinding the spleen through detorsion then splenectomy must be performed. (wikipedia.org)
  • Wandering spleen is most commonly diagnosed in young children as well as women between the ages of 20 and 40. (wikipedia.org)
  • In US, the spleen is readily examined in several positions, including the supine, right lateral decubitus, and prone positions, through the subcostal or oblique intercostal plane, using a 3-5 MHz curved transducer [ 6 ]. (e-ultrasonography.org)
  • Note that the massively enlarged spleen is readily visible, with minimal retraction in the left upper quadrant. (medscape.com)
  • Another mechanical cause of splenic infarct can be the injection of gastric varices in the setting of portal hypertension and gastric variceal bleeding. (medscape.com)
  • Alcoholics, diabetics, and patients who are immunosuppressed are among the most susceptible to splenic abscesses. (medscape.com)
  • Less than 0.5% of all splenectomies, surgical removal of the spleen, are performed due to having this disorder. (wikipedia.org)
  • Although symptoms include an enlargement in the size of the spleen, or a change from the spleen's original position to another location, usually in either other parts of the abdomen or into the pelvis. (wikipedia.org)
  • The spleen is located in the left upper quadrant of the abdomen, posterolateral to the stomach. (e-ultrasonography.org)
  • Knife holes in the stomach are generally much larger than ulcer holes, and can empty prodigious amounts of stomach content into the abdominal cavity. (blogspot.com)
  • The normal spleen shows a uniform echotexture similar to or slightly more hyperechoic than the liver or renal parenchyma. (e-ultrasonography.org)
  • Due to the location of the spleen, tucked under the left hemidiaphragm, referred pain to the left shoulder is also a feature 9 . (radiopaedia.org)
  • The upside is that a person with a perforated ulcer is generally in a lot of pain, and sewing up the hole, cleaning out the food, and copiously irrigating away the acids means s/he is likely to wake up with a smile. (blogspot.com)
  • US reveals a small (1-3 cm), separated, well-circumscribed, round to oval mass with echogenicity identical to that of the spleen ( Fig. 2 ). (e-ultrasonography.org)
  • Bacteremia from an intercurrent infection (eg, pneumonia, cholecystitis, central line sepsis) can colonize a splenic avascular area and form an abscess, as depicted in the image below. (medscape.com)