A rare case report of ruptured splenic abscess causing pneumoperitoneum in a tertiary care centre

Abstract

Splenic abscess is a very rare entity but potentially a life threatening disease. In autopsy studies, the incidence of splenic abscess is found to be 0.05 to 0.7%. The most common cause of splenic abscess is through haematogenous spread. It usually occurs due to spread of infection from endocarditis or some contiguous infection sites. High risk individuals include immunocompromised patients, hemoglobinopathies, and diabetes mellitus. Early in diagnosis of these abscesses can be done by the combination of clinical suspicion and computed tomography scan of the abdomen. The management of these abscesses includes medical therapy, CT-guided percutaneous aspiration, and splenectomy. Recent studies have stressed on the change in clinical spectrum, thereby indicating that intravenous antimicrobial therapy alone for patients with splenic abscess has a significant role in its management. However, many studies reveal that splenectomy is necessary for a ruptured splenic abscess with peritonitis.