Splenic infarction

A Splenic infarction can be the result of various underlying diseases such as leukemia or heart diseases such as atrial fibrillation. This leads to a blockage of blood vessels in the spleen, which leads to circulatory disruption and ultimately to the death of cells in the spleen due to the lack of oxygen.

What is a splenic infarction?

At a Splenic infarction tissue in the spleen dies due to insufficient blood flow. Basically, a distinction is made between acute splenic infarction and chronic recurrent splenic infarction.

Typically, a splenic infarction closes or constricts the splenic artery or its branches, which means that little or no blood can get into the spleen, which leads to tissue death. The most characteristic symptom of occlusion of the blood vessels supplying the spleen is the so-called acute abdomen.

This describes severe abdominal pain, which can also radiate into other parts of the body, such as the shoulders. If left untreated, a splenic infarction can lead to an autosplenectomy, i.e. a loss of complete spleen function.

causes

There are different causes for one Splenic infarction may be the basis. Splenic infarctions are not uncommon for cancers such as chronic myeloid leukemia. An infarction in the spleen can also be triggered by an inflammation of the inner lining of the heart, i.e. endocarditis.

A thromboembolism can also result in a splenic infarction. An embolus is transported through the bloodstream until it gets stuck at some point and blocks an important vessel, such as the splenic artery, which is the most important artery in the spleen. Other common causes of splenic infarction include blood poisoning, inflammation of the arteries, and various infectious diseases.

As a result of sickle cell anemia, the deformed red blood cells cause more frequent occlusion of blood vessels. These recurrent circulatory disorders can also affect the spleen, where they then lead to a splenic infarction.

Symptoms, ailments & signs

A splenic infarction is initially manifested by severe pain in the left upper abdomen, which suddenly occurs and radiates into the surrounding regions. This is accompanied by nausea and vomiting. Typical fever symptoms can also occur, such as increased body temperature, chills, malaise and fatigue.

The pain, which is typically localized in the area of ​​the spleen, increases in intensity over time. Those affected usually have severe pressure pain, combined with sudden sweats and a strong feeling of illness. Externally, a splenic infarction can occasionally be recognized by the noticeable swelling, which may be reddened or painful to the touch.

In addition, ulcers can become noticeable when the organ perforates and the tissue fluid penetrates the surrounding tissue layers. In individual cases, a splenic infarction goes unnoticed. Then the dead tissue becomes scarred, causing the organ to malfunction.

A damaged spleen manifests itself among other things as tiredness during light physical exertion, a lack of appetite, wound healing disorders and excessive bleeding. It can also lead to digestive problems, chronic stomach pain in the area of ​​the organ and hormonal problems. Severe inflammation of the spleen can also occur as a result of a full or partial splenic infarction and be associated with further complications and complaints.

Diagnosis & course

When making the diagnosis, the abdomen is first palpated. Characteristic of one Splenic infarction are left-sided upper abdominal pain appearing out of nowhere, which can radiate into the left shoulder.

Typically, a splenic infarction causes an acute abdomen with very severe upper abdominal pain and fever. The attending physician checks whether he can feel a defensive tension on the patient's left upper abdomen. With these symptoms, a splenic abscess must also be considered as a differential diagnosis. To confirm the suspected diagnosis of splenic infarction, a so-called duplex sonography is performed.

The spleen artery is examined using ultrasound waves. A splenic infarction can usually be seen clearly on ultrasound. If an ultrasound examination does not give a clear result, a computed tomography can also be performed.

Complications

Splenic infarction is a very serious complaint that definitely needs to be treated by a doctor. Without treatment, the affected person can die. For this reason, a doctor should always be consulted in the event of a splenic infarction in order to avoid possible complications. Self-healing is also unlikely.

The patients sometimes suffer from pain in the abdomen. There is also vomiting and nausea. A fever can also occur and the patient experiences severe pain in the spleen. If the complaint is not treated, the spleen can be completely damaged so that it remains without function.

In some cases, the spleen can regenerate itself after the splenic infarction. In severe cases, the spleen must be completely removed. In most cases, there are no particular complications and the person affected can survive without a spleen. However, this makes patients more susceptible to various diseases and infections and must therefore protect themselves better. The splenic infarction may reduce the patient's life expectancy.

When should you go to the doctor?

If there is sudden or severe pain in the upper body, there is a disorder in the organism that must be clarified by a doctor immediately. If chronic pain develops, a medical examination should be initiated. If there are complaints in the area of ​​the upper abdomen, this can indicate a disease of the spleen. A doctor is required in the event of nausea, vomiting and sweating. Swelling, increased body temperature and chills should be examined and treated by a doctor. A doctor should be consulted if disorders such as malaise, fatigue, a lack of appetite and irregularities of the digestive tract occur.

Touch pain and dysfunction should be investigated and treated immediately. In severe cases, there is a risk of organ failure, which potentially increases the risk of life endangering. A doctor should be consulted in the event of disturbances in wound healing, a loss of the usual level of performance or a reduction in internal forces. An unwanted decrease in body weight, emotional abnormalities and a rapid fatigue, a doctor is required. If the day-to-day obligations can no longer be fulfilled, as a loss of strength quickly sets in, a doctor's visit is required. Hormonal problems are another sign of spleen irregularity. If the regulation in the course of the female cycle is disturbed or changes in the complexion occur, a doctor should be consulted.

Treatment & Therapy

Is it a partial Splenic infarction, So if only parts of the spleen tissue are affected, the infarction can take place without symptoms and is often not noticed at all. In such cases, the spleen heals on its own even without medical help, leaving only scar tissue. The formation of this scar tissue can lead to a partial impairment of the function of the spleen.

In the case of recurrent splenic infarctions, the spleen may shrink over time due to the increasing scarring. In acute cases, heparin is often given, which inhibits blood clotting; this is an attempt to clear the blockage of the blood vessels in the spleen. The use of anticoagulants is important, because otherwise the spleen may rupture or the spleen may fail completely.

If there are repeated complaints and problems with the spleen, it often makes sense to remove the spleen. A so-called splenectomy, i.e. the removal of the spleen, is always necessary, without exception, if a complete loss of spleen function has occurred due to the infarction.

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Outlook & forecast

Splenic infarction is associated with a poor prognosis. An infarction of the organ initially results in various physical complaints such as severe pain and nausea. There is also the risk of life-threatening complications such as acute epigastric peritonitis, which develops as a result of bacterial infection of the spleen.

Usually there are serious pre-existing conditions such as myeloid leukemia or splenic vein thrombosis, which in turn cause serious complications and worsen the prognosis. The partial infarction can nevertheless heal without any further consequences, provided it is recognized and treated early on. In the best case scenario, all that remains is a scar.

In the case of a complete infarction, the spleen must be removed. If the organ is missing, there is an increased risk of infections and especially blood poisoning, which is fatal in half of all cases. Limbs have to be amputated again and again. While the quality of life is not necessarily impaired by a splenic infarction, life expectancy is usually reduced.

With age, patients increasingly have to take medication to compensate for the lack of protection provided by the spleen. In addition, medical supervision is necessary in any case, which can be a considerable burden for those affected. The prognosis for a splenic infarction therefore depends on whether it is a partial or a complete splenic infarction.

prevention

Around Splenic infarction To prevent this, diseases such as thrombosis or a generally increased risk of thrombosis should be taken seriously. High blood pressure is also one of the risk factors, because the resulting clumps are more easily flushed through the bloodstream and then get stuck in the splenic artery and lead to a splenic infarction.

Aftercare

Since a splenic infarction is a serious emergency illness, far-reaching, persistent complaints are to be expected, which necessitate constant consultation with the doctor. Depending on whether a serious underlying disease is the trigger, it is important to keep this under control in order to rule out another infarction. Affected people should pay attention to a healthy lifestyle and a balanced diet. Avoid excessive physical exertion. The weakened immune system requires special monitoring, so patients should consult their doctor at the slightest sign of discomfort in order to avert the risk of the condition getting worse.

You can do that yourself

A mild splenic infarction doesn't always require medical attention. The affected person should watch out for unusual symptoms and pain in the area of ​​the spleen in the period after the infarction. There may be scarring of the spleen tissue, which in some cases leads to functional restrictions of the spleen.

The most important self-measure is to avoid further heart attacks. In addition to a change in lifestyle, a comprehensive medical examination is definitely required. Depending on the cause the doctor determines, further action can then be taken. If a thromboembolism is the cause, sport and physiotherapy are recommended. A healthy body weight and the avoidance of luxury foods are successful preventive measures. If blood poisoning was found to be the cause, injuries and illnesses should receive better care in the future. The same applies if the doctor determines an infectious disease as the cause.

A severe splenic infarction can generally not be treated yourself. The most important measure is compliance with the prescribed therapy. In addition, careful attention should be paid to the signals from the body, as severe splenic infarction often results in secondary symptoms that require immediate clarification and treatment.