Thoracic Empyema Revealing a Fistulized Splenic Abscess: A Rare Case
Published: 2020-06-04
Page: 85-89
Issue: 2020 - Volume 3 [Issue 1]
Hamza El Kihal *
Department of Resiratory Diseases, Hospital ‘’20 August 1953’’, University of Hassan II Casablanca, Faculty of Medicine and Pharmacy, UHC Ibn ROCHD, Casablanca, Morocco.
Issam Hamrerras
Department of Visceral Surgical Emergency (P35), University of Hassan II Casablanca, Faculty of Medicine and Pharmacy, UHC Ibn ROCHD, Casablanca, Morocco.
Hajar Arfaoui
Department of Resiratory Diseases, Hospital ‘’20 August 1953’’, University of Hassan II Casablanca, Faculty of Medicine and Pharmacy, UHC Ibn ROCHD, Casablanca, Morocco.
Hasna Jabri
Department of Resiratory Diseases, Hospital ‘’20 August 1953’’, University of Hassan II Casablanca, Faculty of Medicine and Pharmacy, UHC Ibn ROCHD, Casablanca, Morocco.
Wiam El Khattabi
Department of Resiratory Diseases, Hospital ‘’20 August 1953’’, University of Hassan II Casablanca, Faculty of Medicine and Pharmacy, UHC Ibn ROCHD, Casablanca, Morocco.
Hicham Afif
Department of Resiratory Diseases, Hospital ‘’20 August 1953’’, University of Hassan II Casablanca, Faculty of Medicine and Pharmacy, UHC Ibn ROCHD, Casablanca, Morocco.
Mounir Bouali
Department of Visceral Surgical Emergency (P35), University of Hassan II Casablanca, Faculty of Medicine and Pharmacy, UHC Ibn ROCHD, Casablanca, Morocco.
Abdelillah El Bakouri
Department of Visceral Surgical Emergency (P35), University of Hassan II Casablanca, Faculty of Medicine and Pharmacy, UHC Ibn ROCHD, Casablanca, Morocco.
Fatimazahra Bensardi
Department of Visceral Surgical Emergency (P35), University of Hassan II Casablanca, Faculty of Medicine and Pharmacy, UHC Ibn ROCHD, Casablanca, Morocco.
Khalid El Hattabi
Department of Visceral Surgical Emergency (P35), University of Hassan II Casablanca, Faculty of Medicine and Pharmacy, UHC Ibn ROCHD, Casablanca, Morocco.
Abdelaziz Fadil
Department of Visceral Surgical Emergency (P35), University of Hassan II Casablanca, Faculty of Medicine and Pharmacy, UHC Ibn ROCHD, Casablanca, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Subphrenic abscesses, like the splenic abscess, is a collection of infectious origin. It is rare and potentially severe due to local complications. Its diagnosis is difficult given the variable clinical symptomatology. The abdominal computed tomography poses the diagnosis with certainty. It requires emergency medical and surgical treatment. We report the case of a patient with a splenic abscess discovered fortuitously following the radiological exploration of thoracic empyema. The surgical procedure consisted of a total splenectomy with suture of the diaphragmatic fistula and chest drainage of the empyema. The postoperative suites were favourable after 2-year of follow-up.
The splenic abscess is a cause of thoracic empyema and its rupture through a diaphragmatic breach remains a rare etiology, requiring emergency medical and surgical management.
Keywords: Actinomyces viscosus, fistulized splenic abscess, streptococcus milleri, Staphylococcus, thoracic empyema