Unusual solution to abdominal pain with contrast enhanced ultrasound

Splenic infarction might be the symptom onset of an important underlying disease. The possibility of splenic infarction must be inserted into differential diagnosis in all those patients who have pain in the upper left quadrant and/or on the left flank. When faced with a case of splenic infarction in a patient who has flown or climbed to high altitudes, it is appropriate to consider the possibility of an haemoglobinopathy. The diagnosis is far from being obvious for emergency physicians. For these reasons, it is very important to proceed as a multidisciplinary team with appropriate diagnostic examinations. The European Guidelines for non-hepatic applications of contrast enhanced ultrasound suggest the usage of this tool for investigation of suspected ischaemic lesions of the spleen.

[1]  C. Dietrich,et al.  Die EFSUMB-Leitlinien und Empfehlungen für den klinischen Einsatz des kontrastverstärkten Ultraschalls (CEUS) bei nicht-hepatischen Anwendungen : Update 2017 (Langversion) , 2018 .

[2]  Mirko D'Onofrio,et al.  The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound (CEUS) in Non-Hepatic Applications: Update 2017 (Long Version) , 2018, Ultraschall in der Medizin - European Journal of Ultrasound.

[3]  Jennifer P. Wang,et al.  Splenic Infarction: An Under-recognized Complication of Infectious Mononucleosis? , 2018, Open forum infectious diseases.

[4]  F. Piel,et al.  Sickle Cell Disease. , 2017, The New England journal of medicine.

[5]  M. Karçaaltıncaba,et al.  Imaging findings of splenic emergencies: a pictorial review , 2016, Insights into Imaging.

[6]  D. Irwin,et al.  The splenic syndrome in individuals with sickle cell trait. , 2014, High altitude medicine & biology.

[7]  C. Schmidt,et al.  Heftige Oberbauchbeschwerden während eines Langstreckenfluges , 2014, Deutsche Medizinische Wochenschrift.

[8]  R. Petrova-Benedict,et al.  Haemoglobinopathies in Europe: health & migration policy perspectives , 2014, Orphanet Journal of Rare Diseases.

[9]  G. Lock,et al.  [Severe upper abdominal pain during a long distance flight]. , 2014, Deutsche medizinische Wochenschrift.

[10]  A. S. K. Banagala,et al.  Acute massive splenic infarction with splenic vein thrombosis following altitude exposure of a Sri Lankan male with undetected sickle cell trait. , 2012, High altitude medicine & biology.

[11]  S. Walerstein,et al.  Etiology and Management of Splenic Infarction and Splenic Vein Thrombosis: Unusual Causes of Abdominal Pain in Sickle Cell Trait Patient , 2012 .

[12]  P. Rosenthal Lessons from sickle cell disease in the treatment and control of malaria. , 2011, The New England journal of medicine.

[13]  T. Takada,et al.  Sickle cell trait as a cause of splenic infarction while climbing Mt. Fuji. , 2010, Internal medicine.

[14]  Y. Amoateng-Adjepong,et al.  Complications associated with sickle cell trait: a brief narrative review. , 2009, The American journal of medicine.

[15]  D. Chamberland Splenic infarction in an African‐American male with sickle cell trait , 2007, American journal of hematology.

[16]  C. Görg,et al.  Contrast‐Enhanced Sonography for Differential Diagnosis of an Inhomogeneous Spleen of Unknown Cause in Patients With Pain in the Left Upper Quadrant , 2006, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[17]  A. Sheikha Splenic syndrome in patients at high altitude with unrecognized sickle cell trait: splenectomy is often unnecessary. , 2005, Canadian journal of surgery. Journal canadien de chirurgie.

[18]  P. Leander,et al.  Radiology of the spleen , 2001, European Radiology.

[19]  R. Hermann,et al.  The natural history of splenic infarction. , 1986, Surgery.

[20]  P. Lane,et al.  Splenic syndrome at mountain altitudes in sickle cell trait. Its occurrence in nonblack persons. , 1985, JAMA.

[21]  W. Peterson,et al.  Clinical triad of massive splenic infarction, sicklemia trait, and high altitude flying. , 1954, Journal of the American Medical Association.