A Rare Presentation of Chronic Myeloid Leukemia - Splenic Infarction

CML is not an uncommon clinical diagnosis. But most of the times it presents with classical long term history. It causes splenomegaly but a splenic infarct in severe left upper abdominal pain due to perisplenitis of short duration as a sole presenting complaint is a very rare presentation of CML. Splenic infarct is a rare clinical entity that has received increasing clinical attention in the recent years(1). The causes include hematological disorders like sickle cell anaemia, polycythemia, myelofibrosis, leukemia or embolic disorders due to atrial fibrillation, infective endocartitis, prosthetic mitral valve, paradoxical emboli from right heart, HIV associated mycobacterial infection, infections like falciparum malaria, infectious mononucleosis, kala azar, meningococcus, etc and some connective tissue disorders. Splenic infarction occur either due to a sudden occlusion of splenic blood supply due to big embolism or due to gradual infiltration of splenic prarenchyma by hematopoetic cells(2). Ultrasonography (USG) is the initial investigation modality, but contrast enhanced computerized tomography (CECT) is the investigation of choice(3).