Splenic abscess owing to cancer at the splenic flexure: A case report and comprehensive review.

Abstract:

BACKGROUND:The cancer of the splenic flexure of the colon is a rare medical entity with severe morbidity because of its insidious onset. METHODS:We present the case of a 59-year-old male patient with dull left upper quadrant pain, leukocytosis, and anemia. A splenic abscess described as an air-fluid level with splenocolic fistula was found on CT scan imaging. Surgery was done for splenic pus drainage. He was again admitted 2 months later for intestinal obstruction. RESULTS:An exploratory laparotomy showed multiple hard, gray liver nodules as well as a hard mass in the small bowel. Owing to extensive adhesions and a late stage of cancer involvement, the splenic flexure tumor was not resected. A loop transverse colostomy was done and a Coloplast Colostomy bag placed. We also reviewed the literature-linking colon cancer and splenic abscess with specific attention to the carcinoma of the splenic flexure. As the latter invades through the spleen matter, there is the creation of a splenocolic fistula, which allows the migration of normal gut flora into the spleen. This leads to the formation of the splenic abscess. CONCLUSION:This is the 13 case report pertaining to invading colonic cancer causing a splenic abscess. Although the treatment for splenic abscesses is shifting from splenectomy to image-guided percutaneous pus drainage, the few reported cases make the proper management of such complication still unclear.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

Awotar GK,Luo F,Zhao Z,Guan G,Ning S,Ren J,Liu Y,Wang G,Liu P

doi

10.1097/MD.0000000000004941

subject

Has Abstract

pub_date

2016-09-01 00:00:00

pages

e4941

issue

38

eissn

0025-7974

issn

1536-5964

pii

00005792-201609200-00040

journal_volume

95

pub_type

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