Spleen embolism
Introduction
Introduction The phenomenon of abnormal blood-insoluble substances that appear in circulating blood, which runs with blood flow to block the lumen of the blood vessels in the distance, is called embolism. Thrombosis in the splenic vein or external compression of the splenic vein causes partial or complete obstruction of the lumen. Splenic vein embolism is closely related to chronic pancreatitis, and about 45% to 65% of pancreatitis can cause disease. About 21% to 35% are common in tumor compression. Non-cirrhotic portal hypertension is the most important pathophysiological change in this disease. The three major features of non-cirrhotic portal hypertension are: a good liver, a bad splenic vein, and a ruptured gastric varicose vein. The disease occurs in middle-aged people (especially 45 to 50 years old) and males.
Cause
Cause
The embolic particles randomly drift into the branch of the splenic artery, and the same small artery can be embolized by one or more particles. Uneven spleen embolism can cause recurrence of spleen hyperfunction. Hypersplenism is a group of symptoms caused by excessive enhancement of spleen function caused by one or more causes without proper isolation and destruction of blood components.
The embolus can be a solid (such as a blood vessel with a detached blood vessel), a fluid (such as a lipid droplet during a fracture), or a gas (such as air that enters the bloodstream during a venous trauma). Embolization is most common with detached thromboembolism, such as embolism of the pulmonary artery and cerebral arteries. The effect of embolization on the body depends on the location of the embolization, the anatomical features of the blood vessels and the local blood circulation, whether sufficient collateral circulation can be established after embolization, and the type and source of the embolism. Common types of embolism include thromboembolism, fat embolism, gas embolism, amniotic fluid embolism, tumor cell embolism, parasitic embolism, and infectious embolism.
An embolus from the left heart or aortic system, which runs with arterial blood flow, obstructs the small arteries of the spleen.
Examine
an examination
Related inspection
Liver, gallbladder, spleen CT examination blood routine
1. Spleen enlargement: It can be mild, moderate and severe swelling. Hematocytopenia is disproportionate to splenomegaly.
2. Peripheral blood cell reduction: often white blood cells, thrombocytopenia. When whole blood cells are reduced, the degree of cell reduction in each line is also inconsistent. When red blood cells are reduced, it can be pale, dizzy, and palpitations. When granulocytes are reduced, the patient's resistance is reduced, and infection and fever are easy. There is a tendency to hemorrhage when thrombocytopenia occurs.
3. If the patient's spleen function is obvious, splenectomy may be performed. After splenectomy, most patients' white blood cells and platelets can return to normal.
Diagnosis
Differential diagnosis
Differential diagnosis of splenic embolism:
1, primary splenomegaly: primary spleen hyperplasia, non-tropical idiopathic splenomegaly, primary spleen neutropenia, primary spleen whole blood cell reduction, splenic anemia or splenic thrombocytopenia. Because the cause is unknown, it is difficult to determine whether the disease is a different cause of the same cause, or an independent disease that is not related to each other.
2, secondary spleen. Secondary splenomegaly occurs in the following various causes:
1 acute infection with splenomegaly, such as viral hepatitis or infectious mononucleosis.
2 chronic infections, such as tuberculosis, brucellosis, malaria, etc.
3 congestive splenomegaly, portal hypertension, intrahepatic obstructive (such as portal cirrhosis, post-necrosis cirrhosis, biliary cirrhosis, hemosiderosis, sarcoidosis, etc.) and extrahepatic obstruction Sex (with external pressure or thrombosis of the portal vein or splenic vein).
4 inflammatory granuloma such as systemic lupus erythematosus, rheumatoid arthritis, Felty syndrome and sarcoidosis.
5 malignant tumors such as lymphoma, leukemia and cancer metastasis.
6 chronic hemolytic diseases such as hereditary spherocytosis, autoimmune hemolytic anemia and marine anemia.
Type 7 lipidosis such as Gaucher disease and Niemann-Pick disease.
8 myeloproliferative disorders such as polycythemia vera, chronic myeloid leukemia and myelofibrosis.
9 other splenic aneurysms and cavernous hemangioma. Occult spleen, regardless of primary or secondary spleen, due to bone marrow compensatory hyperplasia, so the surrounding blood showed no blood cell reduction. However, once the infection or drugs and other factors inhibit hematopoietic function, it can lead to single or complete cytopenia.
