Asymptomatic Splenic Infarction Following Total Gastrectomy: A Case Report

Area of Science:

• Gastroenterology
• Vascular Surgery
• Oncology

Background:

• Splenic infarction, often linked to thrombotic conditions, typically presents with symptoms like abdominal pain or fever.
• Massive splenic infarction can lead to spleen atrophy or loss, with conservative management being the primary treatment unless complications arise.

Observation:

• A 65-year-old woman underwent open total gastrectomy for gastric adenocarcinoma.
• Postoperatively, she developed asymptomatic extensive splenic infarction, diagnosed via contrast-enhanced CT (CECT) on postoperative day 7.
• Elevated hepatobiliary enzymes were noted concurrently with the splenic infarction diagnosis.

Findings:

• The patient remained asymptomatic despite extensive splenic infarction.
• Conservative management was successful, with a follow-up CECT 3 months later showing significant splenic parenchyma reduction.
• This case highlights the possibility of incidental diagnosis of splenic infarction in the absence of typical symptoms.

Implications:

• Asymptomatic splenic infarction can be incidentally diagnosed post-surgery.
• Conservative management appears effective for extensive splenic infarction in select cases.
• Further research may elucidate the long-term outcomes of spleen atrophy following infarction.