Pavlidis Efstathios T, Martzivanou Eirini K, Symeonidis Nikolaos G, Psarras Kyriakos K, Marneri Alexandra G, Stavrati Kalliopi E, Pavlidis Theodoros E
Aristotle University of Thessaloniki, School of Medicine, Second Surgical Propedeutic Department, Hippocration Hospital, Thessaloniki, Greece.
J Surg Case Rep. 2021 Apr 13;2021(4):rjab048. doi: 10.1093/jscr/rjab048. eCollection 2021 Apr.
Splenic abscesses are rare, difficult to diagnose, difficult to treat and usually appear in immunosuppressed patients. We present the case of a 64-year-old patient with left pleuritic chest pain, anorexia and fever with rigors diagnosed with splenic abscess due to splenic flexure colon cancer. The abscess spontaneously ruptured and the patient was operated on for acute abdomen. Splenectomy and Hartmann's hemicolectomy were performed. The patient was discharged from the hospital and referred to the oncologic department. Continuous spread of infection and especially initiating from a cancer lesion is a usual mechanism of splenic abscess formation. Although computed tomography-guided percutaneous drainage is the treatment of choice, an exploratory laparotomy was necessary in this case because of the rupture of the abscess. It is important for the clinicians to include splenic abscesses and their complications in the differential diagnosis of acute abdomen.
脾脓肿罕见，诊断困难，治疗棘手，且通常见于免疫功能低下的患者。我们报告一例64岁患者，因脾曲结肠癌导致脾脓肿，出现左侧胸膜炎性胸痛、厌食及发热伴寒战。脓肿自发破裂，患者因急腹症接受手术。行脾切除术及哈特曼半结肠切除术。患者出院后转诊至肿瘤科。感染的持续播散，尤其是源于癌性病变，是脾脓肿形成的常见机制。尽管计算机断层扫描引导下经皮引流是首选治疗方法，但由于脓肿破裂，本例患者有必要行剖腹探查术。临床医生在急腹症的鉴别诊断中纳入脾脓肿及其并发症很重要。
