Skip to main content

Advertisement

SpringerLink
Log in

Splenic Infarction as a Delayed Febrile Complication Following Radical Gastrectomy for Gastric Cancer Patients: Computed Tomography-Based Analysis

  • Original Scientific Report
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

The aim of this study was to evaluate the incidence and clinical characteristics of splenic infarction (SI) in gastric cancer patients who have undergone gastrectomy.

Methods

For this study, the medical records of 1084 patients were reviewed and 877 patients were ultimately enrolled. The times of symptom onset, diagnosis of SI, and complete resolution on CT were calculated from the day of the operation. Based on the wedge shape of the SI in all cases, the total volume of the SI was measured based on that of a corn kernel.

Results

Thirty-six patients (4.10%) were diagnosed with SI after gastrectomy; four of these patients (0.45%) developed complications associated with the SI. Total gastrectomy and extended lymph node dissection were risk factors for development of SI. Patients with complications exhibited inflammatory signs between 7 and 10 days after surgery. The mean volume of the SI was 4025.69 mm3. The mean time to complete resolution on the CT scan was 327 days postoperatively. In 30 cases, small branched arteries from the splenic artery that could have caused the SI were retrospectively detected on the preoperative CT scans.

Conclusion

Although the incidence of the SI was low, large volume of the SI is associated with complication development. Measuring the infarction volume via a CT scan may be useful to decide on the treatment strategy. Preoperative 3-D reconstruction of the splenic artery tributaries may help reduce the risk of inadvertent SI.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Zilberstein B, Martins BC, Jacob CE et al (2004) Complications of gastrectomy with lymphadenectomy in gastric cancer. Gastric Cancer 7:254–259

    Article  PubMed  Google Scholar 

  2. Antopolsky M, Hiller N, Salameh S et al (2009) Splenic infarction: 10 years of experience. Am J Emerg Med 27:262–265

    Article  PubMed  Google Scholar 

  3. Akin K, Kosehan D, Cengiz AY et al (2012) Splenic infarction following conventional open gastrectomy in patients with gastric malignancy: a CT-based study. Abdom Imaging 37:609–615

    Article  PubMed  Google Scholar 

  4. Hajime I, Akihito E, Hiroharu N et al (2013) Gastric remnant necrosis following splenic infarction after distal gastrectomy in a gastric cancer patient. Int J Surg Case Rep 4:583–586

    Article  PubMed  PubMed Central  Google Scholar 

  5. Sakran N, Ilivitzki A, Zeina AR et al (2012) Splenic abscess after sleeve gastrectomy: a report of two cases. Obes Facts 5:635–639

    Article  PubMed  Google Scholar 

  6. Schiavo L, Scalera G, De Sena G et al (2015) Nonsurgical management of multiple splenic abscesses in an obese patient that underwent laparoscopic sleeve gastrectomy: case report and review of literature. Clin Case Rep 3:870–874

    Article  PubMed  PubMed Central  Google Scholar 

  7. Yazici P, Kaya C, Isil G et al (2015) Splenic infarction—a rare cause of acute abdominal pain following gastric surgery: a case series. Int J Surg Case Rep 10:88–90

    Article  PubMed  PubMed Central  Google Scholar 

  8. Symeonidis A, Papakonstantinou C, Seimeni U et al (2001) Non hypoxia-related splenic infarct in a patient with sickle cell trait and infectious mononucleosis. Acta Haematol 105:53–56

    Article  CAS  PubMed  Google Scholar 

  9. Tan DC, Low AH, Ong HS et al (2006) Unusual abdominal manifestations of catastrophic antiphospholipid syndrome. Br J Haematol 132:538

    Article  PubMed  Google Scholar 

  10. van Hal S, Senanayake S, Hardiman R (2005) Splenic infarction due to transient antiphospholipid antibodies induced by acute Epstein-Barr virus infection. J Clin Virol 32:245–247

    Article  PubMed  Google Scholar 

  11. O’Keefe JH Jr, Holmes DR Jr, Schaff HV et al (1986) Thromboembolic splenic infarction. Mayo Clin Proc 61:967–972

    Article  PubMed  Google Scholar 

  12. Michels NA (1942) The variational anatomy of the spleen and splenic artery. Am J Anat 70:21–72

    Article  Google Scholar 

  13. Goerg C, Schwerk WB, Goerg K (1991) Splenic lesions: sonographic patterns, follow-up, differential diagnosis. Eur J Radiol 13:59–66

    Article  CAS  PubMed  Google Scholar 

  14. Hwang SH, Park DJ, Jee YS et al (2009) Actual 3-year survival after laparoscopy-assisted gastrectomy for gastric cancer. Arch Surg 144:559–564 (discussion 565)

    Article  PubMed  Google Scholar 

  15. Nores M, Phillips EH, Morgenstern L et al (1998) The clinical spectrum of splenic infarction. Am Surg 64:182–188

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors are grateful for the help of Hyun Kyo Kim for the date collection and organization.

Author information

Authors and Affiliations

  1. Division of Gastrointestinal Surgery, Department of Surgery, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea

    Yoon Ju Jung, Ho Seok Seo, Han Hong Lee, Ji Hyun Kim, Kyo Young Song & Cho Hyun Park

  2. Department of Radiology, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea

    Moon Hyung Choi

Authors
  1. Yoon Ju Jung
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ho Seok Seo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Han Hong Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ji Hyun Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kyo Young Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Moon Hyung Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Cho Hyun Park
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cho Hyun Park.

Ethics declarations

Conflict of interest

All the authors declare that they have no conflict of interests.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 294 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jung, Y.J., Seo, H.S., Lee, H.H. et al. Splenic Infarction as a Delayed Febrile Complication Following Radical Gastrectomy for Gastric Cancer Patients: Computed Tomography-Based Analysis. World J Surg 42, 1826–1832 (2018). https://doi.org/10.1007/s00268-017-4401-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-017-4401-0

Search

Navigation