Pulmonary embolism and splenic infarction in a patient with sickle cell trait

Jeremy Sugarman, Wayne M. Samuelson, Robert H. Wilkinson, Wendell F. Rosse

Research output: Contribution to journalArticlepeer-review

Abstract

A 43 year‐old black man with sickle cell trait documented by hemoglobin electrophoresis presented with severe pleuritic chest pain and hypoxemia three weeks after discharge following abdominal surgery. A pulmonary embolus was diagnosed by angiography and he was treated with heparin; the minimum arterial pO2 was 55 torr while O2 was being administered at a rate of 3 L/min. During this therapy, he developed abdominal pain. Computerized tomography suggested splenic infarction, which was documented by radionuclide liver‐spleen scan and magnetic resonance imaging (MRI); the patient's spleen had been normal at exploratory laparotomy three weeks previously. No source for emboli was identified in the deep venous system by MRI. Although splenic infarction has been reported in patients with sickle cell trait at high altitude, this is the first reported case of splenic infarction secondary to the hypoxemia of pulmonary embolism in a patient with sickle cell trait. The spleen is subject to infarction in sickle cell trait because blood flow is slow through a hypoxemic and acidemic environment. The additional hypoxemia due to pulmonary embolism is presumed, in our patient, to have created a local splenic environment which permitted infarction to occur.

Original languageEnglish (US)
Pages (from-to)279-281
Number of pages3
JournalAmerican journal of hematology
Volume33
Issue number4
DOIs
StatePublished - Apr 1990
Externally publishedYes

Keywords

  • pulmonary embolus
  • sickle cell trait
  • splenic infarction

ASJC Scopus subject areas

  • Hematology

Fingerprint

Dive into the research topics of 'Pulmonary embolism and splenic infarction in a patient with sickle cell trait'. Together they form a unique fingerprint.

Cite this