Splenic infarction medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

There is no specific treatment, except treating the underlying disorder and providing adequate pain relief. Splenectomy is only required if complications ensue; surgical removal predisposes to overwhelming post-splenectomy infections.^[1]

Medical Therapy

Surgery is indicated only in the presence of complications. Otherwise, the infarcted spleen can be left in situ, and the patient is observed. Due to the rarity of this disorder and the largely anecdotal character of many reports, the roles of antibiotics and antiplatelet agents (for the treatment of thrombocytosis) have not been formally addressed. Similarly, no scientifically supported information exists regarding the possible increase in susceptibility to overwhelming postsplenectomy sepsis in these patients.

The principal mainstay of medical therapy is analgesia with either narcotics or nonsteroidal anti-inflammatory agents.

In one series of 59 patients, mortality amounted to 5%.^[2] Complications include a ruptured spleen, hemorrhage, splenic abscess (for example, if the underlying cause is endocarditis) or pseudocyst formation. Splenectomy may be warranted for persistent pseudocysts due to the high risk of subsequent rupture.^[3]

References

↑ Salvi PF, Stagnitti F, Mongardini M, Schillaci F, Stagnitti A, Chirletti P (2007). “Splenic infarction, rare cause of acute abdomen, only seldom requires splenectomy. Case report and literature review”. Ann Ital Chir. 78 (6): 529–32. PMID 18510036.
↑ Nores M, Phillips EH, Morgenstern L, Hiatt JR (1998). “The clinical spectrum of splenic infarction”. Am Surg. 64 (2): 182–8. PMID 9486895. Unknown parameter |month= ignored (help)
↑ Pachter HL, Hofstetter SR, Elkowitz A, Harris L, Liang HG (1993). “Traumatic cysts of the spleen–the role of cystectomy and splenic preservation: experience with seven consecutive patients”. J Trauma. 35 (3): 430–6. PMID 8371303. Unknown parameter |month= ignored (help)

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[pmid18510036-1] Salvi PF, Stagnitti F, Mongardini M, Schillaci F, Stagnitti A, Chirletti P (2007). “Splenic infarction, rare cause of acute abdomen, only seldom requires splenectomy. Case report and literature review”. Ann Ital Chir. 78 (6): 529–32. PMID 18510036.

[pmid9486895-2] Nores M, Phillips EH, Morgenstern L, Hiatt JR (1998). “The clinical spectrum of splenic infarction”. Am Surg. 64 (2): 182–8. PMID 9486895. Unknown parameter |month= ignored (help)

[pmid8371303-3] Pachter HL, Hofstetter SR, Elkowitz A, Harris L, Liang HG (1993). “Traumatic cysts of the spleen–the role of cystectomy and splenic preservation: experience with seven consecutive patients”. J Trauma. 35 (3): 430–6. PMID 8371303. Unknown parameter |month= ignored (help)

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