PMC3021344_01
CT scan demonstrating a small area of intracapsular infarction with minimal inflammation (A). Repeat CT scan at 6 weeks (B) and 3 months (C) demonstrating complete resolution. This case was successfully managed conservatively.
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F2
A computed tomography (CT) scan obtained 19 days postoperatively to investigate these complaints showed a segmental infarction of the upper pole of her spleen (Figure 2A). A follow-up CT scan 1 month later showed a much smaller area of infarct (Figure 2B), and a 3-month scan showed complete resolution (Figure 2C).
PMC3021344_02
CT scan demonstrating an infarction involving the superior pole of the spleen with intense inflammation surrounding the capsule. The indication for splenectomy was persistent pain and fevers.
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F3
The CT scan demonstrated a large segmental infarction (Figure 3).
Arteriogram demonstrating the occluded peripheral splenic arterial branch and several clips. Note the absence of vascular contrast to the superior pole of the spleen. Splenic infarction occurs with peripheral branch occlusion due to limited collateral circulation.
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F4
An arteriogram was performed that confirmed our clinical suspicion of SI resulting from a peripheral splenic artery branch ligation (Figure 4).
Laparoscopic splenectomy was attempted, but intense inflammation involving the diaphragm, liver, and colon required converting to an open procedure.
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F5
As the superior pole of the spleen was approached, intense fibrous, inflammatory adhesions involving the diaphragm, stomach, and left lobe of the liver were encountered (Figure 5).