From the Research
A splenic infarct is typically managed by a hematologist, given the frequent association with hematological disorders, though initial care may involve emergency medicine physicians and subsequent involvement of gastroenterologists or other specialists based on the underlying cause. The management of splenic infarct often requires a multidisciplinary approach, considering the varied etiologies and potential complications. According to the most recent and highest quality study available, 1, cardiogenic emboli are a predominant etiology, and atrial fibrillation is a common underlying condition, suggesting that hematologists play a crucial role in management.
Key Considerations in Management
- The choice of specialist depends on the underlying etiology of the infarct, with hematologists being primary for hematological disorders.
- Initial care involves pain control, hydration, and addressing the underlying cause, which may require input from emergency medicine physicians.
- Gastroenterologists may be involved due to their expertise in abdominal organs and conditions affecting the splenic vasculature.
- Most splenic infarcts are managed conservatively, but complications may necessitate surgical intervention by a general surgeon or interventional radiologist.
Diagnostic Approach
- Early imaging by computed tomography (CT) is highly useful for diagnosis, especially in atypical presentations, as noted in 2 and 1.
- The systematic literature review in 1 revealed an extensive list of conditions underlying splenic infarction, highlighting the need for a comprehensive diagnostic approach.
Outcome and Treatment
- The outcome is generally good, with patients often being discharged after a short hospital stay on anticoagulant treatment, as seen in 1.
- Complications are rare, but when they occur, they may significantly impact morbidity, mortality, and quality of life, emphasizing the importance of early and appropriate management.