2017, Number 2
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Rev Med MD 2017; 8.9 (2)
Post-traumatic splenic abscess manifested as pleuropulmonary syndrome
De la Cruz-Temores S, Islas-Rodríguez JP, Leonher-Ruezga KL, Michel-Mercado IE, Gallegos-Sierra C
Language: Spanish
References: 16
Page: 221-224
PDF size: 522.07 Kb.
ABSTRACT
Splenic abscesses (SA) are composed of one or more infectious foci, commonly involving bacteria and fungi; with a
major predisposition in immunocompromised patients, recent trauma and other infections. We present a male diabetic
patient, who is 49 years old, presents with a diagnostic background of trauma and pneumonia. The patient is
unresponsive to treatment and manifests with fever, cough, dyspnea and pleural effusion. An abdominal CT shows
splenomegaly, hypodensity in the ileum and inferior pole. Trauma to the spleen is associated with hematomas with
microinfarction, which could lead to infection or bacteremia. Therefore, in about 2-4 weeks' post trauma, an abscess
could appear. The classical triad of an SA includes: fever, left hypochondrial pain and leukocytosis; furthermore, it
could also present with pleural effusion.Management of an SA requires a surgical intervention; with splenectomy as
the treatment of choice. Percutaneous drainage and laparoscopy should also be considered.
REFERENCES
1.Constantin F, Giagkos L, et al. Abscesses of the spleen: Report of three cases. World J Gastroenterol, 2008; 14(19): 3088-3091.
2.Morejón GM, Medero T O, et al. Absceso esplénico. Revisión del tema. Rev Cub de Med, 2014;53(1): 91- 96.
3.Peña R, Mendez M, et al. Pneumoperitoneum due to splenic abscess: A diagnostic challenge. Case Report. Cir y Cir, 2015; 83(5):433-437
4.Shetty M, Deme S et al. Experience with Splenic Abscess from Southern India. J Clin Diagn Res. 2016;10(10):22-25.
5.Muñoz JD, Vidal VM, et al. Manejo laparoscópico de un absceso esplénico subsecuente a linfoma no Hodgkin. Cir endosc, 2012;13(4).
6.Susuki K, Akai T, et al. Case report of a splenic abscess due to colon cáncer, Gan To Kagaku Ryoho. 2015;42(12):2227-9
7.Ismail E, El Barni R, et al. Splenic abscess in cancer chemotherapy. BMC Res Notes. 2015;11(8):665
8.Lawrence C. Madof. Mendell, et al. Splenic Abscess. Principals and Practice of infectious Diseases. Update edition 79, 979-981.
9.Fernandez de O, Rodriguez A, et al. Hipercalcemia sintomática como forma de presentación de un caso de tuberculosis esplénica aislada. Med. Clin. Barc. 2012; 130(10); 443-445.
10.Barron R, Chavez G, et al. Splenic rupture secondary to abscess: Rare cause of pneumoperitoneum. Case report, Cir y Cir.
11.Ponsky J, Adheesh S, et al. Management of splenic abscess. Shackelfors sugery of the alimentary tract,7 ed. 2013;137,1655-1658.
12.Krokos, N., Michailidou, E., Karakatsanis, A. et al. Accessory Spleen in Splenic Trauma and Reactive Thrombocytosis Hellenic J Surg. 2011;83:148
13.Nagarsheth K, Splenic Abscess, Encyclopedia of Trauma Care, Springer, 2015; 1517-19
14.Fernández O, Rojas R, et al. Absceso esplénico: una causa rara de shock séptico. Med Intensiva, 2000;24(1):33-36.
15.Pombo, F., Suarez, I., et al. CT-guided percutaneous treatment of solitary pyogenic splenic abscesses, Eur. Radiol. 1991;1(1): 70.
16.Correa JC, Morales CH, et al. Absceso esplénico: ¿drenaje percutáneo o esplenectomía?, Rev Colomb Cir. 2016;31:50-56.
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