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August 1976

Splenic Infarction in Sickle Cell-Hemoglobin C Disease: Demonstration by Selective Splenic Arteriogram and Scintillation Scan

Author Affiliations

From the Hematology and Oncology Section, Veterans Administration Center, Temple, Tex (Dr Yeung), and the Division of Hematology and Oncology, The George Washington University Medical Center, Washington, DC (Dr Lessin).

Arch Intern Med. 1976;136(8):905-911. doi:10.1001/archinte.1976.03630080041014

Splenic infarction with consequent splenic fibrosis and functional asplenia is a common occurrence in patients who have sickle-cell anemia during childhood. It occasionally occurs in adults with the sickle-cell trait under high-altitude conditions where Po2 is decreased, such as during airflight1-9 or mountaineering.10 A number of instances of splenic infarction have been reported in patients with sickle cell-hemoglobin C disease during air travel.2,5,7,9,11-13 The diagnosis of splenic infarction is frequently based on the clinical features of sudden onset of pain in the left upper quadrant of the abdomen with or without associated fever, nausea, vomiting, splenomegaly, or localized friction rub. At times, however, the bedside diagnosis of splenic infarction is difficult and may not be easily differentiated from thromboembolism or infarction of the lower part of the left lung or left kidney.

Recently, radioisotope scintillation scanning of the spleen has been found useful in establishing the