Hemorrhagic infarction and dual blood supply

[ChessMaster3000]

I think i am getting these two concepts confused. I remember learning in med school that you get hemorrhagic infarction in places that have a dual blood supply, ig the lungs, because the lungs can be supplied by the bronchial artery. However, Goljan/Sattar don't mention the dual blood supply with hemorrhagic necrosis, but rather LOOSELY CONNECTIVE TISSUE. Further, the liver is noted to have pale infarcts even though it has a dual blood supply. So, do I need to re-learn that concept? Hemorrhagic infarct isn't related to dual blood supply but just loosely connective tissue?

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[notbobtrustme]

We were taught that hemorrhagic infarcts are the result of thrombotic emboli. These get lodged in a vessel and then the body breaks down the clot, allowing blood to reperfuse the tissue. However, since the tissue downstream has died, blood hemorrhages into the space instead of being neatly sequestered in the vessels.

In contrast, pale infarcts (or coagulation necrosis) are the result of thrombotic events, mostly due to an athereosclerotic plaque rupturing, exposing sub-endothelium collagen. This produces a clot that can't be broken down, resulting in a pale infarct that largely preserves the structure.

Hope that answers your question and I hope I'm not mis-remembering.

 

[Ionian]

Brain: hemorrhagic infarct is the result of re-perfusion (as above)
The body: They occur in soft tissue with dual blood supplies (e.g. lungs, small bowl)
Generally "tough tissue" (Heart, Kidney, Spleen) pale infarcts, especially with a single 'end-artery' supply (kidney, spleen).

An exception I have seen is that if an infarct of the splenic VEIN results in blood back up back into the spleen and results in a 'hemorrhagic' infarct.