Zarei Elham, Pour Mohammad Arash, Vafadar Mehdi, Gholizadeh Mesgarha Milad
Department of Radiology, Ali Asghar Children Hospital, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran.
Faculty of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran.
Radiol Case Rep. 2023 Oct 4;18(12):4380-4383. doi: 10.1016/j.radcr.2023.09.025. eCollection 2023 Dec.
Splenic abscess leading to rupture and pneumoperitoneum is a very rare condition that is limited to a few case reports. In this study, we first introduced a case of an adolescent girl with a medical history of diabetes mellitus who presented with left upper quadrant abdominal pain and fever. Ultrasound revealed an abscess in the spleen and a computed tomography (CT) scan of the abdomen revealed evidence of pneumoperitoneum secondary to the rupture of this abscess. The patient underwent splenectomy without postoperative complications. Secondly, we reviewed and discussed the current literature on this topic which predominantly denotes that the pneumoperitoneum following splenic abscess rupture mostly occurs in the immunocompromised status, without a specific predominant infectious agent but the culprit is a gas-forming organism, acute abdomen ensues if the diagnosis is delayed, diagnosis is via abdominal CT when there is hemodynamic stability otherwise exploratory laparotomy uncovers the diagnosis, and splenectomy with broad-spectrum antibiotic therapy is the mainstay of treatment.
脾脓肿导致破裂和气腹是一种非常罕见的病症，仅有少数病例报告。在本研究中，我们首先介绍了一例患有糖尿病病史的青春期女孩，她出现左上腹疼痛和发热症状。超声检查发现脾脏有脓肿，腹部计算机断层扫描（CT）显示该脓肿破裂继发气腹的证据。患者接受了脾切除术，术后无并发症。其次，我们回顾并讨论了关于该主题的当前文献，这些文献主要表明脾脓肿破裂后的气腹大多发生在免疫功能低下的状态，没有特定的主要感染病原体，但罪魁祸首是产气菌，如果诊断延迟会引发急腹症，当血流动力学稳定时通过腹部CT进行诊断，否则通过剖腹探查术来明确诊断，脾切除术加广谱抗生素治疗是主要的治疗方法。
