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Case Reports
. 2019 May 8;12(5):e228961.
doi: 10.1136/bcr-2018-228961.

Non-traumatic ruptured splenic abscess presenting with pneumoperitoneum in an immunocompetent patient: a diagnostic dilemma

Nitin Agarwal  1 , Ashish Sharma  2 , Gaurav Garg  2
Affiliations
Case Reports

Non-traumatic ruptured splenic abscess presenting with pneumoperitoneum in an immunocompetent patient: a diagnostic dilemma

Nitin Agarwal et al. BMJ Case Rep. .

Abstract

Splenic abscess is a rare life-threatening clinical entity. There are only a handful of reported cases of spontaneous splenic abscess rupture with pneumoperitoneum. Rupture of splenic abscess associated with gas-producing pathogens may lead to pneumoperitoneum. We hereby report the case of a ruptured splenic abscess with pneumoperitoneum in a young immunocompetent woman masquerading as hollow viscus perforation peritonitis. Ruptured splenic abscess should be kept in mind for treating surgeons as a differential diagnosis of pneumoperitoneum or peritonitis, particularly for immunocompromised patients.

Keywords: gas/free gas; gastroenterology; gastrointestinal surgery; general surgery.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
X-ray abdomen erect showing free gas under right hemidiaphragm.
Figure 2
Figure 2
Intraoperative specimen image showing severely damaged and congested spleen after spontaneous rupture of splenic abscess.
See this image and copyright information in PMC

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