AB156. SOH24AB_273. Primary splenic abscess in an immunocompetent adult female patient: a case report

Background: Primary splenic abscess is rare and typically present in patients who are immunocompromised. We present a case of a 47-year-old immunocompetent female patient who was diagnosed with primary splenic abscess following emergency laparotomy. Case Description: A 47-year-old female patient presented with subjective fevers and severe epigastric and left flank pain. She treated empirically with intravenous piperacillin/tazobactam and gentamycin and resuscitated with intravenous crystalloid infusion. A radiological diagnosis of splenic infarct secondary to splenic artery aneurysm with superimposed splenic abscess was presumed, however at emergency laparotomy, primary splenic abscess was identified. This abscess had eroded the left hemidiaphragm and ruptured the splenic capsule, leading to intraabdominal pus in the pelvis. A splenectomy and primary repair of the left hemidiaphragm was performed, with postoperative pancreatitis diagnosed following the procedure. After intensive care treatment, this patient made a full recovery. Conclusions: In accordance with 'gold standard' recommendations, this case of primary splenic abscess was treated successfully with a combination of surgery (i.e., splenectomy and surgical drainage), robust antimicrobial therapy, and meticulous intensive care in the perioperative period.