The spleen is a lymphatic organ located in the body's upper left abdominal quadrant. It filters and stores red blood cells, removes bacteria and other microorganisms and produces white blood cells for immunity. If blood flow is interrupted to the spleen by an object such as a blood clot or piece of plaque or because of trauma, infection or certain diseases, the affected portions of the spleen die due to lack of oxygen. This condition is referred to as splenic infarction. Two of the more serious complications of splenic infarction include abscess and rupture.
Signs and Symptoms
The symptoms of splenic infarction are dependent upon the extent and severity of damage to the spleen and the causative factor. In mild cases, symptoms may be completely absent; however, most people experience upper left abdominal or left flank pain and, less commonly, radiating left shoulder pain, nausea, vomiting and lower left chest pain. The most common sign is tenderness of the upper left abdominal quadrant. Less common signs may occur due to a complication of infarct and include fever, hypotension, tachycardia, abdominal distension and altered mental status.
Splenic infarction can sometimes cause the spleen to rupture and hemorrhage. Diagnosis of this type of splenic rupture -- nontraumatic -- is problematic, as its symptoms can be mistaken for heart attack, appendicitis or acute pancreatitis. Again, the most common symptom is upper left abdominal pain that may radiate to the left shoulder. Common signs include hypotension and tachycardia, which can be signs of impending hemorrhagic shock. In addition, abdominal distension and an upper left abdominal mass may be present.
An infarcted spleen can result in splenic abscess if the infarction is caused by bacteria. Symptoms include acute upper abdominal pain with radiating shoulder pain and lower left chest pain. Signs include fever, vomiting and upper abdominal tenderness. If treatment for the abscess is delayed, sepsis can result. Sepsis is caused by bacteria entering the bloodstream and spreading to other tissues and organs of the body. If untreated, sepsis can lead to septic shock, characterized by extreme hypotension, tachycardia and altered mental status.
Seeking Medical Help
People suffering from splenic infarction may delay treatment due to an initial lack of symptoms or because symptoms are mild. If a condition is present that predisposes them to any type of infarction, they should seek help if they begin to notice left upper abdominal pain that may radiate to the left shoulder or tenderness in the left upper abdomen. Fever with these symptoms could mean an abscessed spleen. Signs of impending hemorrhagic shock along with these symptoms could mean a ruptured spleen. Either can cause death, so medical attention should be immediate.