Introduction:

The splenic abscess is an unusual entity that is observed in immunosuppressed patients due to diseases such as diabetes mellitus (DM), hemato-oncological diseases, acquired immunodeficiency syndrome (AIDS) and, to a lesser extent, in subjects who presented trauma or splenic infarction. The ideal treatment is splenectomy, although conservative alternatives such as percutaneous drainage and laparoscopic resection should be considered. We present a case of a patient with a diagnosis of splenic abscess due to salmonellosis, this being rare.

Clinical case:

A 53-year-old male patient with type 2 DM. Refers to diffuse abdominal pain of insidious onset of moderate intensity, colic type, concomitant liquid stools and temperature rises 40°. On physical examination HR: 114 bpm FR: 28 rpm BP: 130/70mmHg. Abdomen: globular, RsHs present, depressible, painful on palpation with signs of peritoneal irritation. The chest X-ray shows pneumoperitoneum. A xiphopubic laparotomy was performed, finding 1500ml of purulent fluid, a ruptured splenic abscess and hepatomegaly. Splenectomy + lavage and cavity drainage is performed.

Conclusion:

Splenic abscesses are a rare entity with non-specific clinical manifestations. Diagnostic methods, tomography is the study of choice. Pneumoperitoneum can confuse the diagnosis, being carried out late, which is why we must have it as a differential diagnosis. Splenectomy is the definitive treatment; percutaneous drainage is performed in selected patients.