Splenic infarction as a rare cause of abdominal pain in older adults: A case report

Abstract

Spontaneous splenic infarction has been rarely reported within aged population. The diagnosis of the condition is based on clinical findings and splenic imaging. In recent years, ultrasonography and computed tomographic scan have gained in popularity for the diagnosis of splenic infarction. Most reported cases are focal infarctions, and treatment is mostly conservative. We described the case of a 82-year-old female with cured breast cancer, paroxysmal atrial fibrillation, hypertension who had left upper quadrant pain within 15 days. Physical examination on admission revealed a palpable splenomegaly. Abdominal computed tomography scan showed many subcapsular infarct zones of the spleen measuring 16 cm in length and 4.5 cm conglomerate lymphadenopathies within periportal region. Doppler ultrasound revealed wedge-shaped heterogeneous hypoechoic avascular areas and lymphadenopathies. After laboratory tests, the underlying cause was found as marginal zone
 lymphoma. The patient was treated with conservative management and chemotherapy was planned for specific cause. Splenic infarction must be kept in mind for older patients with underlying comorbidities presenting with acute left upper quadrant pain.