부산대학교 도서관

Splenic abscess is relatively rare. We experienced an extremely rare case of splenic abscess associated with descending colon cancer. The patient was a 72-year-old man with chief complaints of high fever and chill. Blood culture grew Gram-positive bacillus. He was admitted under the diagnosis of sepsis and anemia on examination. Abdominal ultrasonography and computed tomography showed splenic abscess, portal venous gas and wall thickening of the descending colon. Colonoscopy revealed type-2 descending colon cancer in the splenic flexure. The preoperative diagnosis was sepsis and splenic abscess due to colonic penetration associated with descending colon cancer and direct invasion into the pancreas tail. Partial resection of the transverse colon and descending colon, splenectomy and limited resection of the pancreas tail were performed. The lesion, located in the descending colon, had penetrated the pancreas, the spleen, and induced abscess. The pathological examination revealed that the splenic abscess had not developed as a direact extension of the colon cancer but the cancer spread near the spleen. Cultures of the abscess obtained during the operation grew nothing. Surgical resection is the first choice of therapy for splenic abscess developing from colon cancer.