Splenic Infarction: An Unusual Condition with Numerous Difficult Options: A Case-Report, Literature Review and Surgical Observations

Abstract

Splenic infarction is a rare cause of acute abdomen whose aetiology is stratified according to age group. In patients under the age of 40 most causes are attributable to hematological or genetic pathologies, while in patients over 40 years old, the thromboembolic manifestations play a major role. The diagnosis of splenic infarction can be almost an enigma for the doctor who is evaluating a patient with non-specific abdominal pain, possible hyperpyrexia or rise in phlogosis and LDH indexes. The scientific literature on splenic infarction is rather scarce and consists mostly of articles with few cases. In this article, with the help of a rather emblematic clinical case that has come to the attention of the Emergency Department of the S. Anna Hospital in Ferrara, and subsequently to the Surgery Unit, we want to reflect not so much on the diagnosis of this pathology but rather on the therapeutic strategies following the diagnosis. Is splenic infarction a pathology of surgical interest? On what terms and times should surgical treatment be proposed to the patient? Is there an alternative to surgery? How should follow-up be conducted in these patients? These are questions to which the literature currently available has not yet been able to answer and, in the future, we hope we will start researches on the treatment of a condition which does not seem to be so rare.