Massive splenic infarction in a patient with pneumococcal septic shock and unknown celiac disease

Splenic infarction (SI) is a rare event occurring when the splenic artery or its branches become occluded by embolus or by in situ thrombosis. Many SI events are a result of embolic sources either cardiac or aortic. Massive splenic infarction (MSI) results from compromised blood flow to more than half of the spleen. In this paper we describe a case of a previously healthy patient who presented with pneumococcal sepsis who, upon investigation, revealed an unknown celiac disease and a MSI. Abdominal ultrasound with contrast agent was a useful tool for a diagnosis and follow up of this patient.