The spleen is an important organ that is involved in hematopoiesis and immunity. Her tissues are vulnerable to various adverse effects. One of the dangerous diseases is spleen infarction. Symptoms of the pathology may not appear immediately, so patients do not always consult a doctor in a timely manner. But without treatment, this disease leads to serious complications. How to recognize the first signs of pathology? And how to repair a damaged organ? We will consider these issues in the article.
What it is
A special artery is responsible for the blood supply to the spleen. If the lumen of the vessel narrows due to spasm or becomes clogged with a blood clot, the organ's nutrition is sharply disturbed. Ischemia occurs, and then tissue necrosis. If necrotic changes appear in the organ due to circulatory disorders, then doctors diagnose spleen infarction.
The disease is more common in older people. This is due to age-related changes in the vessels. Pathology is observed with equal frequency in men and women.
Etiology
What can lead to necrosis of the tissues of the hematopoietic organ? Doctors distinguish the following causes of spleen infarction:
- Oncological diseases of the blood forming organs (leukemia, lymphoma). These pathologies lead to blockage of the splenic artery by blood clots.
- Change in blood composition. A decrease in hemoglobin and an increase in platelet counts contribute to the appearance of clots in the vessels.
- Heart diseases. With cardiological pathologies, blood circulation slows down, which leads to malnutrition of the spleen tissues.
- Vascular pathologies (vasculitis, atherosclerosis, endarteritis). These diseases are accompanied by narrowing of the lumen of blood vessels and circulatory disorders.
- Abdominal injuries. Bruises of the spleen often provoke the formation of blood clots in the arteries of the organ. In case of rib fractures, the vessels may be damaged by bone fragments.
- Infectious pathologies. Against the background of general intoxication of the body, spasm of the splenic artery occurs, which leads to a deterioration in the blood supply to the organ.
- Neoplasms in the spleen. Tumors in this organ compress the vessels. This causes ischemia, and then heart attack.
- Long-term use of hormonal contraceptives. A side effect of estrogen is thrombosis.
Types of pathology
Symptoms, treatment and prognosis of spleen infarction largely depend on the form of pathology. Doctors distinguish the following varieties of this disease:
Consider these forms of the disease in more detail. Coronary spleen infarction occurs due to acute blockage of the splenic artery or its branches. As a result, the organ is very poorly supplied with blood. A change in the color of tissues is a characteristic sign of the ischemic form of spleen infarction. A description of the color of the organ can be found in special medical literature. His tissues become very pale due to a lack of blood supply. Therefore, this form of pathology is also called white heart attack.
With a hemorrhagic kind of heart attack, the organ is full of blood. The splenic artery is clogged. However, blood enters the organ bypasses, and its outflow is impaired. Hemorrhagic heart attack also occurs due to venous stasis. Foci of necrosis appear in the spleen, which look like hematomas.
Initial manifestations
If the focus of necrosis is small, then the patient may not feel any unpleasant symptoms. Quite often, at an early stage, patients do not notice manifestations of ischemia. The spleen contains very few nerve endings. Therefore, at the beginning of the pathology, pain is absent.
The initial symptoms and first signs of spleen infarction appear only in a slight general malaise and weakness. A person experiences unreasonable fatigue, which does not go away even after a long sleep and intensifies in the morning. The patient's working capacity decreases, he gets tired very quickly. However, patients usually do not associate such manifestations with spleen pathology. A visit to a doctor is often delayed.
A mild pain syndrome may be an early symptom and first sign of spleen infarction in women. Unpleasant sensations appear on the left under the ribs. In men, there is no initial pain. This is due to the fact that women have less developed muscles of the abdomen, and the spleen is more mobile.
In addition, women are more likely to suffer from spleen cysts. The cause of this disease can be hormonal disruptions. A cyst is usually accompanied by soreness. Organ ischemia occurs due to vascular compression of the tumor. Therefore, symptoms of spleen infarction are more pronounced in women than in men.
Detailed symptoms
As already mentioned, patients rarely begin treatment at the initial stage of the disease. If the violation of blood supply continues, the focus of ischemia increases with time. New areas of necrosis appear in the tissues. The following symptoms of spleen infarction are characteristic of this stage:
- Pain syndrome. Pain occurs on the left side under the ribs and radiates to the back. At first, discomfort appears periodically, most often after physical exertion. As ischemia develops, the pain syndrome becomes permanent.
- Dyspeptic symptoms. Digestive disorders are observed in patients: nausea, diarrhea, lack of appetite.
- Deterioration of general well-being. In patients, the temperature rises to +39 degrees, shortness of breath and frequent palpitations are noted.
- A feeling of heaviness and fullness under the ribs on the left. Such a symptom is more often noted with a hemorrhagic form, when blood stasis forms in the spleen.
On palpation, an increase in the spleen is determined. Palpation of the organ is accompanied by severe soreness.
With extensive splear infarction, the symptoms of pathology are even more pronounced. The pains become unbearable. They radiate to the back, stomach and chest. Often, patients take such manifestations as signs of heart disease or gastrointestinal tract. In the future, intestinal obstruction, severe constipation and bursting pains in the abdomen develop.
Complications
Launched spleen infarction is dangerous for its complications. Without treatment, this disease can lead to the following consequences:
- Abscess of the spleen. Dead tissue is very susceptible to infection. If bacteria penetrate into them, then an abscess forms in the organ. If an abscess breaks into the abdominal cavity, then this can lead to blood poisoning and peritonitis. These conditions threaten the life of the patient.
- Bleeding from an organ. Such a complication is possible with a hemorrhagic form of a heart attack. Overfilled vessels burst, and blood flows into the abdominal cavity.
- Spleen brush In necrotic areas, benign tumors filled with fluid may form.
In addition, the affected areas become very vulnerable to all adverse effects. With organ ischemia, even a small physical activity or bruise can cause tissue rupture.
Diagnostics
Diagnosing this disease is sometimes quite difficult. Indeed, at the initial stage, severe symptoms may be absent. The surgeon begins the examination with an external examination of the patient and probing the right hypochondrium. With palpation, an increase in the organ is determined, in the later stages, pain when pressed.
In order to determine the nature of the pathology, the following diagnostic procedures are prescribed:
- Ultrasound Spleen infarction can be easily detected using ultrasound. The examination shows an increase in the organ and changes in the structure of tissues in the foci of ischemia.
- MRI This is the most accurate diagnostic method. Using tomography, you can determine the localization and size of the areas of necrosis.
- Duplex scanning. This study shows changes in the splenic artery and its branches.
- Spleen biopsy. This diagnostic procedure is rarely prescribed, as it is rather traumatic. However, puncture is necessary in cases of suspected complications. Under local anesthesia, the doctor makes a puncture in the spleen and takes a piece of tissue for microscopy.
In some cases, a clinical blood test is prescribed. But in the initial stages, this test is uninformative. Blood counts may remain normal. Only in the later stages are there signs of anemia, as well as an increase in white blood cells and ESR.
Conservative therapy
If the foci of necrosis are small, then a conservative treatment of spleen infarction is possible. The patient is advised to avoid any physical exertion and observe bed rest.
To reduce pain, cold compresses are shown on the spleen area. Analgesics and antispasmodics are also prescribed:
- Ibuprofen
- Ketanov.
- "Analgin."
- "Baralgin."
- "Spazmalgon."
With an ischemic form of pathology, the drug "Warfarin" is prescribed. It is an anticoagulant that prevents thrombosis. However, with hemorrhagic infarction, this remedy is strictly contraindicated, since it can provoke bleeding.
In the early stages, injections of the Fibrinolysin preparation are prescribed. It cleaves fibrin strands, from which blood clots subsequently form.
For prophylactic purposes, antibiotics are prescribed:
- Ciprofloxacin.
- "Azithromycin".
- Erythromycin.
- Ceftriaxone.
Antibacterial therapy helps prevent infection of affected tissues and the formation of an abscess.
Surgical methods
With an extensive heart attack, as well as a high risk of complications, surgery is necessary. During surgery, dead tissue or the entire organ is removed. Currently, operations on the spleen are carried out mainly by laparoscopic methods.
Even complete removal of the spleen does not adversely affect the health of the patient. In this case, the bone marrow or liver take on the function of hematopoiesis. Recovery after surgery takes several weeks. During the rehabilitation period, you must follow a sparing diet and wear a special bandage. After surgery, the patient is shown a course of drug therapy. Analgesics, antibiotics, immunomodulators and anticoagulants are prescribed.
Power Features
As already mentioned, the spleen is responsible for blood formation. With pathologies of this organ, the patient decreases hemoglobin and red blood cell counts. Therefore, foods rich in iron should be regularly included in the diet. This element is necessary for the normal formation of blood cells.
Iron is found in the following products:
- beef and pork liver;
- lungs;
- buckwheat;
- sea kale;
- grenades;
- citrus fruits;
- walnuts.
It is necessary to limit the amount of salt in the diet and completely eliminate alcohol. Alcohol adversely affects the work of the hematopoietic organ.
Folk remedies
It is impossible to cure the pathology of the spleen with home remedies alone. However, traditional medicine recipes can be used at the recovery stage, for example, after surgery. It is recommended to use decoctions of the following plants:
- daisies;
- calendula
- sage;
- hypericum.
These herbs have an anti-inflammatory effect. Their use contributes to the rapid restoration of damaged tissues.
Forecast
With timely drug therapy or surgery, a complete cure is possible. However, the overall health of a person affects the outcome of the disease. If a heart attack is triggered by dangerous pathologies (for example, heart disease or leukemia), then the prognosis worsens. The hemorrhagic form of a heart attack is more difficult to treat than ischemic.
Mortality in this pathology is less than 1.5%. A fatal outcome is noted in the presence of complications such as multiple abscesses, sepsis, peritonitis, as well as with severe bleeding.
Prevention
How to prevent the occurrence of a hematopoietic heart attack? Surgeons advise to observe the following recommendations:
- Protect the abdomen from bruises and other injuries.
- Limit cholesterol foods. Such food contributes to the development of atherosclerosis, and this is one of the causes of circulatory disorders.
- In time to cure infectious diseases, as well as pathologies of the heart and blood vessels.
- Avoid lifting weights.
- While taking hormonal contraceptives, regularly take a blood test for clotting and platelet counts.
These measures will significantly reduce the risk of spleen ischemia.