SPLENIC INFARCTION DETECTED BY TC-99M RBC SCINTIGRAPHY

A 53-year-old man with a history of gallstone pancreatitis and pancreatic pseudocyst was admitted with obstructive Jaundice, abdominal pain, fever, and chills. Gastrointestinal bleeding developed, and a labeled red blood cell scan was obtained that demonstrated asymmetric tracer activity in the splenic bed. A lateral image revealed a large wedge-shaped defect in the midbody of the spleen with a smaller defect seen posteriorly. Computed tomography scan showed evidence of a pancreatic abscess and multiple splenic defects. At surgery, the abscess was drained and a splenectomy performed. Pathology revealed evidence of a large acute splenic infarct, as well as several small splenic infarcts.