Delayed splenic abscess after blunt abdominal trauma in the 24- year-old woman: diagnostic difficulties and dilemma

Abstract

Primary splenic abscess with unknown origin is rare and it could be mistaken with other conditions. We present a 24-year-old woman with abdominal pain and weight loss without fever or related symptoms. In ultrasound examination ill-defined anechoic mass-like lesion was evident, located near the splenic vein in retroperitoneum with spleno-systemic shunt. Patient underwent laparoscopy for ruling out malignancy but severe inflammation and adhesion-bands prevent further laparoscopic exploration. One week later patient's condition was deteriorated and she underwent second surgical exploration. In laparotomy spleen was surrounded by an abscess wall and splenectomy was done. Histopathological examination revealed subcapsular splenic hemorrhage with abscess formation.