A Case of Splenic Abscess and Infarction Caused by Chronic Pancreatitis

Kazushige Shibahara, Takaaki Iwase and Hideki Fujimori

Department of Surgery, Hokuriku Central Hospital

A rate case of splenic abscess and infarction caused by chronic pancreatitis. A78-year-old man was admitted with a sudden high fever (39°C) and sudden severe pain in the left upper quadrant of the abdomen. Ultrasonography and computed tomography suggested abscess and infarction of the spleen and left subphrenic abscess. Splenectomy and peritoneal drainage were performed based on the diagnosis of peritonitis due to the rupture of a splenic abscess. Histopathological examination of the resected specimen revealed chronic pancreatitis, wide infarction and an abscess of the spleen. The wall of the artery showed inflammatory infiltration and the lumen was obstructed by thrombogenesis. These findings suggested that inflammation of the chronic pancreatitis spreading to the splenic artery, and caused splenic infarction. Simultaneously, inflammation of the pancreas spread directly to the spleen and caused the splenic abscess.

Key words
chronic pancreatitis, splenic abscess, splenic infarction

Reprint requests
Kazushige Shibahara Department of Surgery I, Kanazawa University School of Medicine 13-1 Takaramati, Kanazawa, 920-8641 JAPAN

Accepted
October 14, 1998

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