Cui Fang, Zhu Rongfeng, Qian Zhangjun, Zhang Yunlei
Department of Oncology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, Jiangsu Province, China.
Ultrasound Medical Imaging Department, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, Jiangsu Province, China.
Medicine (Baltimore). 2024 Dec 13;103(50):e40936. doi: 10.1097/MD.0000000000040936.
Splenic metastases concomitant with abscesses are rare and challenging for clinicians. The primary treatment options include splenectomy and ultrasound-guided percutaneous perforation and drainage.
A case of splenic abscess in a colon cancer patient with splenic metastasis who developed chills and fever for approximately 2 weeks. However, the best broad-spectrum antibiotics are ineffective. Moreover, the patient had a high bleeding risk for percutaneous perforation due to a low platelet count.
Colon cancer, splenic metastasis, splenic abscess, thrombocytopenia.
Ultrasound-guided percutaneous splenic abscess perforation and drainage were performed after platelet transfusion and stimulation of platelet production in the bone marrow.
His fever was immediately relieved at night and thrombocytopenia did not relapse thereafter. His platelet count increased rapidly and reached 121 × 109/L 3 days later.
Spleen metastasis in tumor patients necessitates vigilance for the potential development of spleen abscess. A less invasive procedure can be feasible in cases of low platelet count without significant coagulation dysfunction. When there is no alternative therapeutic schedule, doctors should fully evaluate the risks and benefits.
脾脏转移瘤合并脓肿较为罕见，给临床医生带来挑战。主要治疗选择包括脾切除术以及超声引导下经皮穿刺引流。
一名结肠癌伴脾脏转移的患者出现脾脏脓肿，寒战、发热约2周。然而，使用最佳的广谱抗生素治疗无效。此外，患者因血小板计数低，经皮穿刺存在高出血风险。
结肠癌、脾脏转移、脾脏脓肿、血小板减少症。
在输注血小板并刺激骨髓生成血小板后，进行了超声引导下经皮脾脏脓肿穿刺引流。
当晚其发热立即缓解，此后血小板减少症未复发。其血小板计数迅速上升，3天后达到121×10⁹/L。
肿瘤患者出现脾脏转移时，必须警惕脾脏脓肿的潜在发生。对于血小板计数低且无明显凝血功能障碍的患者，采用侵入性较小的手术可能是可行的。当没有其他治疗方案时，医生应充分评估风险和益处。
