Splenectomy for E. coli abscess: A case report with a difficult preoperative diagnosis and unclear pathogenesis

Marco Casaccia; Simona Macina; Rosario Fornaro; Marco Frascio; Tommaso Testa; Cesare Stabilini; Ezio Gianetta

doi:10.1016/j.ijscr.2016.04.027

Splenectomy for E. coli abscess: A case report with a difficult preoperative diagnosis and unclear pathogenesis

Int J Surg Case Rep. 2016:25:48-50. doi: 10.1016/j.ijscr.2016.04.027. Epub 2016 Apr 19.

Authors

Marco Casaccia¹, Simona Macina², Rosario Fornaro¹, Marco Frascio¹, Tommaso Testa¹, Cesare Stabilini¹, Ezio Gianetta¹

Affiliations

¹ Surgical Clinic Unit II, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Italy.
² Surgical Clinic Unit II, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Italy. Electronic address: simona.macina@gmail.com.

Abstract

Introduction: Isolated splenic abscess is a rare clinical condition and remains a diagnostic dilemma. Clinical presentation is non-specific and the diagnosis is often delayed. Ultrasonography and CT scan are the gold standard. The treatment is still controversial: antibiotic therapy, percutaneous drainage (PCD) or splenectomy.

Case presentation: We present the clinical case of a patient, admitted to our Department because of abdominal pain, without fever. The preoperative radiological assesment showed three intrasplenic liquid collections, whose differential diagnosis was made between hematic collection and abscess. The treatment was splenectomy. The samples of collected liquid were positive for Escherichia Coli.

Conclusion: In case of splenic abscess, splenectomy is the best therapeutic choice. The other therapeutical options like antibiotic therapy and PCD, can be used only in particular cases, but without the same efficacy.

Keywords: Splenectomy; Splenic abscess; Splenic hematic collection.