The spleen is enlarged. Involving the lateral aspect an ill-defined region of low density is seen, abutting the capsule. Incidental note is made of a small region of hepatic focal fatty change in segment 4 abutting the ligament teres.
Within the limits of a non contrast study, remaining solid abdominal viscera and hollow viscus structures, including bowel, are normal. The appendix is normal (not shown).
Conclusion
Low density region within an enlarged spleen suggests the presence of a splenic infarct may account for the patient's presentation. The underlying cause for the patient's splenomegaly is not evident on this scan.
Further assessment with contrast enhanced CT is recommended to confirm the diagnosis and evaluate for other regions of infarction.