[Carcinoma of the left colic angle presenting as an intrasplenic gas collection (author's transl)]

A 65-year-old man was hospitalised for a subocclusive state, fever, 15 kg weight loss and left abdominal pain. The plain abdominal film revealed gas in the left hypochondrium. Barium enema showed a stenosis of the left colic angle. On evacuation, a little barium entered the gas-filled cavity. Left colectomy with splenectomy was carried out. The pathologist found histological evidence of a small carcinoma of the colon invading the hilum of the spleen. An intrasplenic cavity had been formed at the site of contact. Thus an intrasplenic gas collection was the presenting sign of a carcinoma of the colon. Two colosplenic fistulae of similar origin have been reported in the literature; neither associated with similar radiological findings.