Primary splenic abscess in an adult female patient: a case report.

Autor: Isik B; University of Limerick School of Medicine, Co. Limerick, Republic of Ireland. 21149747@studentmail.ul.ie.; Department of Surgery, University Hospital Limerick, Dooradoyle, Co. Limerick, Republic of Ireland. 21149747@studentmail.ul.ie., Davey MG; Department of Surgery, University Hospital Limerick, Dooradoyle, Co. Limerick, Republic of Ireland., Gaffney S; Department of Anaesthesia and Intensive Care, University Hospital Limerick, Dooradoyle, Limerick, Ireland., Stapleton PJ; Department of Microbiology, University Hospital Limerick, Dooradoyle, Co. Limerick, Republic of Ireland., Mohigefer J; Department of Histopathology, University Hospital Limerick, Dooradoyle, Co. Limerick, Republic of Ireland., Koutroumanos E; Department of Surgery, University Hospital Limerick, Dooradoyle, Co. Limerick, Republic of Ireland.
Jazyk: angličtina
Zdroj: Surgical case reports [Surg Case Rep] 2024 Mar 01; Vol. 10 (1), pp. 50. Date of Electronic Publication: 2024 Mar 01.
DOI: 10.1186/s40792-024-01849-2
Abstrakt: Background: Primary splenic abscess is rare and typically presents in patients who are immunocompromised. We present a case of a 47-year-old apparently immunocompetent female patient who was diagnosed with primary splenic abscess from a Salmonella Typhimurium infection following emergency laparotomy.
Case Presentation: A 47-year-old female patient presented with subjective fever and severe epigastric and left flank pain. She was treated empirically with intravenous piperacillin/tazobactam and gentamicin and was resuscitated with intravenous crystalloid infusion. A radiological diagnosis of splenic infarct secondary to splenic artery aneurysm superimposed with splenic abscess was presumed, however at emergency laparotomy, primary splenic abscess was identified. This abscess had eroded the left hemidiaphragm and had ruptured the splenic capsule leading to intra-abdominal pus in the pelvis which on culture grew Salmonella Typhimurium. A splenectomy and primary repair of the left hemidiaphragm were performed, with postoperative pancreatitis diagnosed following the procedure. After intensive care treatment, this patient made a full recovery.
Conclusion: This case of primary splenic abscess was treated successfully with a combination of surgery (i.e.: splenectomy and surgical drainage), prolonged antimicrobial therapy, and intensive care in the perioperative period.
(© 2024. The Author(s).)
Databáze: MEDLINE
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