Goerg C, Schwerk W B
Department of Internal Medicine, Philipps University, Marburg, Federal Republic of Germany.
Radiology. 1990 Mar;174(3 Pt 1):803-7. doi: 10.1148/radiology.174.3.2406785.
Forty splenic infarcts in 23 patients were examined with ultrasound (US). At clinical presentation, splenic infarction was associated with severe left upper quadrant pain (n = 10) or diffuse abdominal pain (n = 4) or was asymptomatic (n = 9). In this retrospective study, predominantly wedge-shaped (n = 17) or round (n = 23), irregularly delineated (n = 33) or smooth (n = 7), hypoechoic (n = 40) and anechoic (n = 5) lesions were found at first examination. During follow-up observation, four patients died because of complications unrelated to infarct, and five patients underwent splenectomy as a consequence of US findings. Expanding intralienal liquefaction, increasing subcapsular hemorrhage, free peritoneal blood (even in spleens shown to have an intact surface at sonography), and flow phenomena in the area of infarction demonstrated at B-mode pulsed Doppler US were identified as infarct-related complications associated with the risk of splenic rupture. Despite the high self-healing tendency in splenic infarction, short-term follow-up with US is recommended for early recognition of these possible complications.
对23例患者的40处脾梗死灶进行了超声（US）检查。临床表现方面，脾梗死与严重左上腹疼痛（n = 10）或弥漫性腹痛（n = 4）相关，或无症状（n = 9）。在这项回顾性研究中，初次检查时主要发现为楔形（n = 17）或圆形（n = 23）、边界不规则（n = 33）或光滑（n = 7）、低回声（n = 40）和无回声（n = 5）的病灶。在随访观察期间，4例患者因与梗死无关的并发症死亡，5例患者因超声检查结果接受了脾切除术。B型脉冲多普勒超声显示的梗死灶内液化扩大、包膜下出血增加、腹腔内游离血液（即使在超声检查显示脾脏表面完整的情况下）以及梗死区域的血流现象被确定为与脾破裂风险相关的梗死相关并发症。尽管脾梗死有较高的自愈倾向，但仍建议进行短期超声随访以早期识别这些可能的并发症。
