What are the indications for anticoagulation in splenic infarctions?

A great reminder that splenic infarct relates to ARTERIAL thromboembolism and not to VENOUS VTE. Too often, I see massive, blind thrombophilia work-up for (incidentally) detected splenic infarcts.

Splenic infarctions should be thoroughly worked up. There are multiple scenarios. 1) Exclude splenic arterial dissection. This is extremely rare, however, important. The next step would be to look for the source of emboli. 2) The most common source is cardiac, generally atrial fibrillation. Therefor...