SPLENIC INFARCTION

SPLENIC INFARCTION

Definition Spontaneous splenic infarction is a rare condition where a portion of the spleen suddenly dies due to a blockage in one of its blood vessels.

Types

1. Splenic arterial thrombosis → occlusion of the splenic artery → infarction of the spleen.
2. Splenic venous thrombosis → occlusion of the splenic vein → infarction of the spleen.

Causes

1. Atherosclerosis → thickening and hardening of the splenic artery → reduced blood flow → infarction.
2. Splenic artery embolism → blockage of the splenic artery → infarction.
3. Splenic vein thrombosis → blockage of the splenic vein → infarction.
4. Sickle cell disease → abnormal red blood cells → blockage of small blood vessels → infarction.
5. Malaria → infection of red blood cells → blockage of small blood vessels → infarction.
6. Trauma → injury to the spleen → damage to blood vessels → infarction.
7. Infections → bacterial or fungal infections → inflammation of blood vessels → infarction.
8. Tumors → cancer cells → invasion of blood vessels → infarction.
9. Blood clotting disorders → abnormal blood clotting → blockage of blood vessels → infarction.

Clinical Features

1. Abdominal pain → severe pain in the left upper quadrant of the abdomen.
2. Nausea and vomiting → feeling queasy and vomiting.
3. Fever → elevated body temperature.
4. Abdominal tenderness → tenderness on palpation of the abdomen.
5. Splenomegaly → enlargement of the spleen.
6. Leukocytosis → elevated white blood cell count.
7. Anemia → low red blood cell count.
8. Thrombocytopenia → low platelet count.
9. Splenomegaly → enlargement of the spleen.

Diagnostic Approaches

1. Laboratory tests → complete blood count (CBC) → check for anemia, leukocytosis, and thrombocytopenia.
2. Imaging studies → computed tomography (CT) scan → visualize the spleen and surrounding structures.
3. Ultrasound → check for splenomegaly and abdominal tenderness.
4. Splenic angiography → visualize the splenic artery and vein.
5. Splenic biopsy → collect tissue sample from the spleen.

Complications

1. Infection → bacterial or fungal infections → peritonitis or abscess formation.
2. Hemorrhage → bleeding from the infarcted spleen.
3. Sepsis → life-threatening condition caused by infection.
4. Multi-organ failure → failure of multiple organs → death.

Management

1. Supportive care → manage symptoms → pain control, hydration, and nutrition.
2. Surgical intervention → remove the infarcted spleen → splenectomy.
3. Anticoagulation therapy → prevent further blood clots → warfarin or heparin.
4. Antibiotics → treat bacterial infections → broad-spectrum antibiotics.
5. Anti-fungal therapy → treat fungal infections → amphotericin B.

Treatment

1. Splenectomy → surgical removal of the spleen.
2. Splenic artery revascularization → restore blood flow to the spleen.
3. Splenic vein revascularization → restore blood flow to the spleen.
4. Supportive care → manage symptoms → pain control, hydration, and nutrition.

Homoeopathic Therapeutic Medicines

1. Arsenicum album → treat acute symptoms of splenic infarction.
2. Belladonna → treat pain and inflammation.
3. Bryonia → treat pain and inflammation.
4. Gelsemium → treat weakness and fatigue.
5. Nux vomica → treat abdominal pain and nausea.
6. Phosphorus → treat anemia and thrombocytopenia.
7. Silica → treat spleen enlargement and inflammation.
8. Sulphur → treat infection and sepsis.

Operative Method

1. Splenectomy → surgical removal of the spleen → splenectomy. → Step 1 → Incision in the abdomen → Step 2 → Exposure of the spleen → Step 3 → Removal of the spleen. → Step 4 → Ligation of the splenic artery and vein → Step 5 → Closure of the incision.

Clinical Anatomy

1. Blood supply → splenic artery and vein.
2. Nerve supply → splenic plexus.
3. Clinical relevance → splenic infarction → abdominal pain, nausea, and vomiting.