Spleen: Injury & Infarction

Injury & Infarction

Splenic Injury

  • *See Trauma: Spleen Trauma
  • Most Common Iatrogenic Splenic Injury During Abdominal Surgery: Capsule Tearing Due to Forceful Retraction of Omentum for Exposure

Splenic Rupture

  • Traumatic Rupture (Most Common)
  • Pathologic Rupture
    • Rupture Secondary to Underlying Pathology
    • Causes:
      • Hematologic Malignancy – Leukemia/Lymphoma (Most Common)
      • Malaria (Most Common Infectious Cause in World)
      • Mononucleosis (Most Common Infectious Cause in the US)
      • Pancreatitis
  • Spontaneous Rupture
    • Rupture in a Histologically Normal Spleen
    • Very Rare – Non-Traumatic Causes are Most Likely Pathologic

Splenic Infarction

  • Sx: Fever, Pain, Nausea, Vomiting & Splenomegaly
    • May Have Similar Presentation as Splenic Abscess
    • May Develop Splenic Abscess
  • Most Common Causes: Hematologic (59%) & Hypercoagulable (29%) Disorders
  • Tx: Pain Control & Anticoagulation
    • If from Sickle Cell Disease: Fluid Resuscitation; Not Anticoagulation