Imaging Pearls ❯ Spleen ❯ Sequestration
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- “Acute splenic sequestration crisis, the sudden pooling of red blood cells in the spleen, is an emergent process typically seen in children with homozygous sickle cell disease. Splenic sequestration has rarely been reported in adults with heterozygous sickle cell conditions, including sickle cell beta(+)-thalassemia disease (HbS/β+-thalassemia).”
Splenic sequestration in the adult: cross sectional imaging appearance of an uncommon diagnosis
Yonah B. Esterson, Sheila Sheth, Satomi Kawamoto
Clinical Imaging VOLUME 69, P369-373, JANUARY 01, 2021 - “Acute splenic sequestration crisis results from the trapping (or “sequestration”) of red blood cells in the spleen of a person with sickle cell disease. The pooling and destruction of blood cells within the spleen results in decreased circulating blood volume, potentially leading to hypovolemic shock, cardiovascular collapse, and even death. Clini- cally, splenic sequestration crisis is defined as a drop in hemoglobin level by 2 g/dL in the setting of an enlarging spleen.”
Splenic sequestration in the adult: cross sectional imaging appearance of an uncommon diagnosis
Yonah B. Esterson, Sheila Sheth, Satomi Kawamoto
Clinical Imaging VOLUME 69, P369-373, JANUARY 01, 2021 - “CT will show an enlarged spleen with a thick irregular rim of peripheral low attenuation repre- senting infarcts and hemorrhage. Alternatively, CT may show larger, more diffuse areas of hypoattenuation within an enlarged spleen. Similar to CT, ultrasound will demonstrate an irregular peripheral hypoechoic rim within an enlarged spleen. Both modalities will demonstrate patency of the splenic artery and vein.”
Splenic sequestration in the adult: cross sectional imaging appearance of an uncommon diagnosis
Yonah B. Esterson, Sheila Sheth, Satomi Kawamoto
Clinical Imaging VOLUME 69, P369-373, JANUARY 01, 2021 - "On cross sectional imaging, differential considerations for splenic sequestration include subcapsular splenic hematoma and splenic infarction. However, a subcapsular splenic hematoma classically appears as a lenticular or crescentic perisplenic collection which smoothly flattens the splenic contour as opposed to the irregular appearance at the periphery of the splenic tissue seen in sequestration. Splenic infarction typically appears as a single or multiple, peripheral, wedge-shaped area (s) of hypoattenuation as opposed to the more diffuse peripheral hypoattenuation associated with splenic sequestration.”
Splenic sequestration in the adult: cross sectional imaging appearance of an uncommon diagnosis
Yonah B. Esterson, Sheila Sheth, Satomi Kawamoto
Clinical Imaging VOLUME 69, P369-373, JANUARY 01, 2021