Candidaabscess of the pancreas: diagnosis and treatment by computed tomography-guided percutaneous drainage

Candida albicans is found frequently as a commensal organism in the gastrointestinal tract. Despite this, it is rarely found in pancreatic abscesses, there being less than 10 cases in the literature (Richter et al, 1982). We report the case of a patient in whom computed tomography (CT) was used initially to diagnose a pancreatic fluid collection complicating a splenectomy. Computed tomography was then used during diagnostic aspiration followed by definitive treatment of what was shown to be an abscess by placement of a percutaneous drainage catheter under CT guidance. A diagnosis of myelofibrosis was made 15 months before splenectomy in a 65-year-old man. Splenectomy had been decided upon because of the necessity of more frequent blood transfusions and the increasing size of the spleen, with associated pain. At operation, numerous adhesions were found between the spleen, peritoneum and abdominal organs. The tail of the pancreas extended into the hilum of the spleen. The resected spleen weighed 2400 g (normal c. 400 g) and microscopic examination showed changes compatible with myelofibrosis. A second laparotomy was required within 24 h because of bleeding vessels in the region of the body of pancreas.