Sigmoid colon perforation with splenic abscess due to ulcerative colitis: A case report and review of the literature

INTRODUCTION AND IMPORTANCE: The occurrence of abscesses in the spleen, a substantial abdominal organ with hematopoietic function, is relatively rare in clinical cases and mostly occurs in immunodeficient populations. The early symptoms of splenic abscess are not obvious, and the diagnosis is usually confirmed by a combination of patient symptoms, imaging manifestations and blood culture results. CASE PRESENTATION: A 36-year-old male patient was treated in the emergency room for severe lower abdominal pain and discomfort. An abdominal CT(Computed Tomography) examination initially suggested an acute bowel perforation and an enlarged and abnormally thick spleen. The patient first underwent a repair of the bowel perforation, which was followed by fever and no reduction in abdominal symptoms, while the patient's splenic abscess was then treated with a repeat splenectomy. CLINICAL DISCUSSION: Splenic abscesses mostly occur in immunocompromised patients. The treatment of splenic abscesses includes simple antibacterial medication, percutaneous puncture placement for drainage, and splenectomy for drainage. In our case, the treatment of this patient's splenic abscess was divided into several stages, and we finally used splenectomy for drainage because the patient's symptoms were not significantly better than before and combined with coagulation abnormalities. CONCLUSION: In patients with severe abdominal infection and relevant ancillary tests suggesting abnormal spleen size and density, it is also important to consider whether a splenic abscess has formed and to provide early diagnosis and treatment of splenic abscess while fighting abdominal infection.