Underlying thrombotic conditions in patients with splenic infarction: a 10-year retrospective analysis.

BACKGROUND: Splenic infarction is a rare but clinically important condition that is usually associated with underlying hematological, cardiovascular, infectious, or malignant diseases. Due to its nonspecific clinical presentation, diagnosis may be delayed. This study aimed to evaluate the demographic characteristics, clinical findings, etiological factors, radiological features, treatment approaches, and outcomes of patients diagnosed with non-traumatic splenic infarction. METHODS: This retrospective study included 67 adult patients diagnosed with splenic infarction by contrast-enhanced abdominal computed tomography (CT) at Dicle University Faculty of Medicine Hospital between January 2014 and December 2023. Demographic characteristics, presenting symptoms, laboratory parameters, radiological findings, etiological factors, treatment modalities, length of hospital stay, and in-hospital mortality were evaluated. RESULTS: The mean age of the patients was 50.9 ± 16.3 years, and 64.2% were male. Abdominal pain was the most common presenting symptom and was present in all patients. Hematological disorders were the most common identifiable specific etiology (31.3%), while no identifiable cause was found in 23.9% of patients. Contrast-enhanced CT established the diagnosis in all patients, whereas ultrasonography detected infarction in only 29.9% of cases. JAK2 mutation analysis was positive in 4 of 16 tested patients with hematological disorders. Conservative management was sufficient in 89.6% of patients, while 10.4% required splenectomy because of splenic rupture, hemorrhagic infarction, or splenic abscess formation. In-hospital mortality occurred in four patients (6.0%). CONCLUSIONS: Splenic infarction is an uncommon clinical entity that should be considered in patients presenting with unexplained abdominal pain, particularly in the presence of hematological or systemic disorders associated with thrombotic risk. Contrast-enhanced CT remains the most reliable diagnostic modality, whereas ultrasonography has limited sensitivity. Although conservative management is effective in most patients, severe complications may necessitate surgical intervention. Early diagnosis and comprehensive etiological evaluation are essential for appropriate management and improved clinical outcomes. CLINICAL TRIAL NUMBER: Not applicable.