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Case report
Unusual solution to abdominal pain with contrast enhanced ultrasound
  1. Sara Montemerani1,
  2. Luca Castellani2,
  3. Gianni Guazzi3 and
  4. Marcello Pastorelli1
  1. 1Department of Emergency Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
  2. 2Department of Internal Medicine, IRCCS, AOU San Martino, Genova, Italy
  3. 3Department of Emergency Radiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
  1. Correspondence to Dr Sara Montemerani; sara.montemerani{at}


Splenic infarction might be the symptom onset of an important underlying disease. The possibility of splenic infarction must be inserted into differential diagnosis in all those patients who have pain in the upper left quadrant and/or on the left flank. When faced with a case of splenic infarction in a patient who has flown or climbed to high altitudes, it is appropriate to consider the possibility of an haemoglobinopathy. The diagnosis is far from being obvious for emergency physicians. For these reasons, it is very important to proceed as a multidisciplinary team with appropriate diagnostic examinations. The European Guidelines for non-hepatic applications of contrast enhanced ultrasound suggest the usage of this tool for investigation of suspected ischaemic lesions of the spleen.

  • emergency medicine
  • haematology (incl blood transfusion)
  • radiology
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  • Contributors SM and LC handled the clinical case, MP reviewed the work and GG executed ultrasound examinations.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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