Amjad Siraj Memon, Jawahar Rathore, M M Dahri.
Splenic Abscess.
Med Channel Jan ;5(4):36-8.

A morbidily obese (110kg) 45-year-old lady was admitted in our unit with a 6 weeks history of high-grade fever. She also had continuous pain in left flank since 2 weeks. Pain was dull and aggravated by lying on the affected side with radiation to left shoulder (Kehr`s Sign). She was febrile (101.5F) and had tachycardia (104 per min). She was tender in left upper quadrant. Full blood counts revealed raised leucocytes (14,300 per ul) and urine examination was normal. Blood sugar, urea, electrolytes and clotting profile were within normal limits. Diagnosis was established on ultrasound and CT scans. The CT scan showed an enlarged spleen with intact capsule and a large homogenous hypodense area divided by septations. There were also enlarged coeliac and superior mesentric lymph nodes. She was given broad-spectrum antibiotics (Ampicillin & Gentamycin) parenterally. Gradually her fever, pain and tenderness subsided. A CT guided percutaneous drainage was performed with drainage of 220ml of blood stained pinkish pus. There was no major procedure related complication. The culture of the pus grew E. Coli sensitive to Cefixime on which patient was kept and discharged 3 days after the procedure. She was followed weekly with serial ultrasound scans which showed decreasing abscess size and the antibiotic therapy was stopped after four weeks.

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