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 impaired blood flow and ultimately to the death of cells in the spleen due to the lack of oxygen.
What is a splenic infarction?
In a splenic infarction, tissue in the spleen dies due to a lack of blood flow. Basically, a distinction is made between an acute splenic infarction and a chronic, recurrent splenic infarction. See AbbreviationFinder for abbreviations related to Splenic Infarction.
Typically, a splenic infarction blocks or narrows the splenic artery or its branches, which means that little or no blood can get into the spleen, which leads to the death of the tissue. The most characteristic symptom of an occlusion of the blood vessels supplying the spleen is the so-called acute abdomen.
This describes severe abdominal pain, which can also radiate to 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 all spleen function.
Causes
There are various causes that can underlie a splenic infarction. Splenic infarctions are not uncommon in 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. It involves transporting an embolus through the bloodstream until it eventually gets stuck, blocking an important vessel such as the splenic artery, which is the main artery of the spleen. Other common causes of splenic infarctions are blood poisoning, inflammation of the arteries and various infectious diseases.
As a result of sickle cell anemia, blood vessels are more likely to become blocked due to the deformed red blood cells. These recurring 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 occurs suddenly and radiates to the surrounding regions. This is accompanied by nausea and vomiting. In addition, typical fever symptoms can occur, i.e. 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 sweating and a strong feeling of illness. Externally, a splenic infarction can occasionally be recognized by the noticeable swelling, which can be red or very painful when touched.
Ulcers can also become noticeable when the organ perforates and tissue fluid leaks into the surrounding tissue layers. In isolated cases, a splenic infarction goes unnoticed. The dead tissue then scars, causing the organ to malfunction.
A damaged spleen manifests itself, among other things, in fatigue during light physical exertion, lack of appetite, wound healing disorders and excessive bleeding. Indigestion, chronic stomach pains in the area of the organ and hormonal problems can also occur. 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 symptoms.
Diagnosis & History
When making the diagnosis, the abdomen is first palpated. A splenic infarction is characterized by left upper abdominal pain that appears out of nowhere and can radiate to the left shoulder.
Typically, a splenic infarction causes an acute abdomen with severe upper abdominal pain and fever. The treating doctor checks whether he can feel a defensive tension on the left upper abdomen of the patient. With this clinical picture, a spleen abscess must also be considered as a differential diagnosis. A so-called duplex sonography is performed to secure the suspected diagnosis of a splenic infarction.
The splenic artery of the spleen is examined using ultrasound waves. A splenic infarction is usually clearly visible on ultrasound . If an ultrasound examination does not produce any clear findings, a computer tomography can also be carried out.
Complications
The splenic infarction is a very serious complaint that must be treated by a doctor in any case. Without treatment, it can lead to the death of the person concerned. 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.
Patients sometimes suffer from abdominal pain. There is also vomiting and nausea. Fever can also occur and the patient suffers from 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 attack. In severe cases, the spleen must be completely removed. In most cases, there are no particular complications and the affected person can survive without a spleen. However, this makes patients more susceptible to various diseases and infections and therefore requires better protection. The life expectancy of the patient may be reduced as a result of the splenic infarction.
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 immediately by a doctor. 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 for 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, exhaustion, a lack of appetite and irregularities of the digestive tract occur.
Pain on touch and dysfunction should be promptly evaluated and treated. In severe cases, there is a risk of organ failure and this potentially increases the risk of life being endangered. A doctor should be consulted in the case of wound healing disorders, a loss of the usual level of performance and a reduction in internal strength. An unwanted decrease in body weight, emotional abnormalities and a tendency to tire quickly, a doctor is needed. If the daily obligations can no longer be fulfilled because a loss of strength quickly sets in, a doctor’s visit is necessary. Hormonal problems are another sign of spleen irregularity. If regulation during the course of the female menstrual cycle is disrupted or if there are changes in the complexion,
Treatment & Therapy
If it is a partial splenic infarction, i.e. only parts of the spleen tissue are affected, the infarction can take place without symptoms and is often not even noticed. In such cases, the spleen will heal on its own without medical attention, leaving only scar tissue. The formation of this scar tissue can lead to partial functional impairment of the spleen.
In the case of recurrent splenic infarctions, the spleen can shrink after a while due to increasing scarring. In acute cases, heparin is often given, which inhibits blood clotting; in this way an attempt is made to clear the blockage of the blood vessels in the spleen. The use of anticoagulants is important because otherwise it can lead to a rupture of the spleen or a complete failure of the spleen’s function.
If there are repeated complaints and problems with the spleen, it often makes sense to remove the spleen. A so-called splenectomy, i.e. removal of the spleen, is always necessary without exception if the infarction has resulted in a complete loss of spleen function.
Outlook & Forecast
A 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. In addition, there is a risk of life-threatening complications such as acute upper abdominal peritonitis, which develops as a result of a bacterial infection of the spleen.
Serious pre-existing conditions such as myeloid leukemia or splenic vein thrombosis are usually the cause, which in turn cause serious complications and worsen the prognosis. However, the partial heart attack can heal without further consequences if it is recognized and treated early. In the best case, only a scar remains.
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 in particular 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.
In old 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 represent a considerable burden for those affected. The prognosis for a splenic infarction depends on whether it is a partial or a complete splenic infarction.
Prevention
In order to prevent splenic infarcts, diseases such as thrombosis or an increased risk of thrombosis in general should be taken seriously. High blood pressure is also one of the risk factors because the clumps that form 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, extensive, persistent symptoms are to be expected, which make permanent consultation with the doctor indispensable. Depending on whether a serious underlying disease is the trigger, it is important to keep it under control in order to rule out another heart attack. Those affected should ensure a healthy lifestyle and a balanced diet. Avoid excessive physical exertion. The weakened immune system requires special monitoring, so at the slightest sign of discomfort, patients should consult their doctor in order to timely avert the risk of worsening the condition.
You can do that yourself
A mild splenic infarction does not always require medical treatment. However, the affected person should watch out for unusual symptoms and pain in the area of the spleen in the period after the heart attack. 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 must be carried out in any case. Depending on the cause that the doctor determines, further measures can then be taken. If a thromboembolism is the cause, sport and physiotherapy are recommended. A healthy body weight and avoiding stimulants are successful preventive measures. If blood poisoning was determined to be the cause, injuries and illnesses should be treated better in the future. The same applies if the doctor identifies an infectious disease as the cause.
In principle, a severe splenic infarction cannot be treated by yourself. The most important measure is compliance with the prescribed therapy. In addition, you should pay close attention to the body’s signals, as a severe splenic infarction often leads to secondary symptoms that require immediate clarification and treatment.