What is a splenic infarction?
In a splenic infarction, a blood clot causes a (partial) blockage of the main artery of the spleen, the so-called lienal artery or one of its branches. The oxygen and nutrient supply is no longer guaranteed due to the blocked vessel. Depending on where the vessel is blocked, this results in an undersupply of certain areas of the spleen or, in the worst case, the entire spleen. The lack of supply ultimately leads to the death of the cells located there. In this context, physicians refer to this as tissue necrosis.
The symptoms
A classic symptom of a splenic infarction is severe left-sided pain in the upper abdomen. Some patients suffer from pain in the left arm in addition to abdominal discomfort. This phenomenon is known as pain radiation.
Nausea and vomiting may also occur. A fever can also appear as part of a splenic infarction. When the above-mentioned symptoms occur, physicians also speak of an acute abdomen. The acute abdomen usually indicates an illness or undersupply of an organ in the abdominal cavity and requires immediate medical clarification.
The diagnosis
If a splenic infarction is suspected, a special ultrasound examination is usually performed. This is a Doppler sonography. Here, ultrasound waves can be used to examine the vascular supply of the spleen in addition to the visualization of tissue. Doppler sonography is usually sufficient to diagnose a splenic infarction. In a few cases, computer tomography (CT) is also performed.
The treatment
The treatment depends on the size of the infarct. For small vessels, often only supportive measures are taken. Those affected are usually treated with pain medication and placed under observation for the time being.
The small area of tissue affected by the infarct then heals with scarring. The remaining part of the spleen can, however, continue to fulfill its function. In the case of a larger, acutely existing infarct, anticoagulants can be administered.
These are drugs that prevent further “clot formation” (thrombus). If the vascular occlusion has already led to the death of a large part of the tissue in the spleen, the spleen must be completely removed. This procedure is called splenectomy.
In addition to the therapy of a splenic infarction, the cause or trigger of the infarction should always be identified and treated. Blood-thinning drugs, such as heparin, are used to treat acute vascular clots (thrombus). They influence the coagulation processes, thus reducing the risk of further thrombus formation. Depending on the cause of a splenic infarction, they can also be taken prophylactically, i.e. to prevent a further infarction.
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