Ruptured splenic abscess with pneumoperitoneum secondary to chronic pyelonephritis

Abstract

Splenic abscesses are relatively uncommon occurrences with autopsy studies estimating the incidence to be between 0.2% to 0.07% [1]. However, the mortality rate from splenic abscesses remains high, especially for immunocompromised patients [2]. The best course of treatment is still unclear, but current literature demonstrates that early detection and source control have been shown to improve outcomes [2]. There are several management options available, including treatment with antibiotics, percutaneous and surgical drainage. However, surgical intervention is currently considered the standard of care due to its effectiveness compared to percutaneous drainage, which has a high inefficacy rate ranging from 14.3% to 75% [3]. Additionally, splenic abscesses pose a diagnostic challenge due to their non-specific presentation. Recent advancements in imaging modalities, such as CT scans and Ultrasonography (US), have led to higher detection rates. US, in particular, has been instrumental in detecting splenic abscesses, due to its affordability, safety, accessibility, and precision [3].