A Case Report of Splenic Abscess due to Colonic Penetration Associated with Transverse colon Cancer

Masakazu Ohno, Naoyuki Miyazaki, Naoya Katayama, Eisen Arahi, Yasuhide Shimada, Takahiro Fujimori*

Department of Surgery, Hyogo Prefectural Kaibara Hospital
*Department of Second Pathology, Kobe University School of Medicine

Splenic abscess is relatively rared. We experienced an extremely rare case of splenic abscess caused by colonic penetration associated with transverse colon cancer. The patient was a 67-year-old woman with a chief complaint of periunbilical pain and vomiting. She was admitted under the diagnosis of ileus for niveau on abdominal X-P and severe leukoplasia. Abdominal ultrasonography and computed tomography showed multilocular splenic abscess. Colonoscopy and contrast enema revealed, 2´ type transverse colon cancer in the splenic flexura. The preoperative diagnosis was ileus and splenic abscess due to colonic penetration associated with transverse colon cancer. Partial colectomy, splenectomy and peritoneal drainage were performed after 14 days from colonostomy. The lesion, located in the transverse colon, penetrated the spleen and induced multilocular abscess. The pathological examination revealed that the splenic abscess developed from a direct extension of the colon cancer. Cultures of the abscess grew Escherichia coli. Surgical resection is the first choice of therapy for splenic abscess developing from direct penetration of colon cancer.

Key words
colon cancer, colonic penetration, splenic abscess

Reprint requests
Masakazu Ohno Department of Surgery, Hyogo Prefectural Kaibara Hospital
5208-1 Kaibara, Kaibara-cho, Hikami-gun, Hyogo, 669-33 JAPAN

Accepted
September 13, 1995

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