A case of splenic abscess complicated with intra-abdominal free gas misdiagnosed as gastrointestinal perforation

The authors present a case of splenic abscess accompanied by intra-abdominal free gas, which was initially misdiagnosed as gastrointestinal perforation. This patient presented with acute onset, severe symptoms, and marked abdominal tenderness. Imaging studies, including chest X-ray and abdominal computed tomography (CT), revealed free gas in the abdominal cavity, leading to the misdiagnosis. However, intraoperation exploration identified no perforation. Postoperative abdominal enhanced CT and multidisciplinary consultation confirmed a splenic abscess. The patient was successfully treated with ultrasound-guided percutaneous drainage and meropenem antibiotic therapy, resulting in complete recovery.