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[Pneumoperitoneum due to splenic abscess: a diagnostic challenge. Case Report]

Emilio Peña-Ros¹, Marcelino Méndez-Martínez¹, María Vicente-Ruiz¹

¹Servicio de Cirugía General y del Aparato Digestivo, Hospital General Universitario Reina Sofía, Murcia, España.

Cirugia Y Cirujanos

|July 13, 2015

Summary

Splenic abscess is a rare condition often diagnosed late. This case highlights its association with pneumoperitoneum, complicating diagnosis and necessitating splenectomy for ruptured abscesses.

Area of Science:

Abdominal Surgery
Infectious Diseases
Radiology

Background:

Splenic abscess incidence rises with immunosuppression.
Endocarditis and gram-positive aerobes are common causes.
Non-specific symptoms delay diagnosis.

Observation:

A 55-year-old male presented with abdominal pain and fever.
CT scan revealed pneumoperitoneum and peri-splenic bubbles.
Laparotomy confirmed a ruptured splenic abscess with purulent peritonitis.

Findings:

Splenectomy was performed due to abscess rupture.
Fluid cultures were negative for microorganisms.
Patient recovered and was discharged post-operatively.

Implications:

Pneumoperitoneum associated with splenic abscess can mimic visceral perforation.
Suspect splenic abscess with unexplained pneumoperitoneum.
Splenectomy is often the treatment of choice for ruptured splenic abscess.

Keywords:

Absceso esplénico Infección Infection Neumoperitoneo Pneumoperitoneum Splenic abscess

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