Presentation
Fever since 15 days, abdominal pain and vomiting for 3 days.
Patient Data
Multiple hypoechoic rounded lesions in the spleen with few of them showing internal septae with no intralesional vascularity was seen, in keeping with multiple splenic abscesses.
Right pleural effusion. Free fluid in peritoneal cavity.
Cholelithiasis with contracted gall bladder and fatty infiltration of the liver.
Incidentally detected small vesical calculus.
Hepatosplenomegaly, multiple hypodense splenic lesions, bilateral pleural effusion and mild free fluid in peritoneal cavity.
Note cholelithiasis with contracted gall bladder, mild fatty infiltration of liver and small vesical calculi.
Case Discussion
Patient presented with fever and blood investigations revealed leukocytosis. There was no history of trauma or pancreatitis. The lesions were rounded with few internal septae.
On imaging the possibility of splenic abscesses was kept. Ascites and pleural effusions also supported inflammatory pathology. Primary splenic hydatid disease was kept as a differential however there were no calcifications or detached membranes on imaging. Hydatid serology was negative.
On ultrasound guided aspiration purulent material was aspirated confirming the diagnosis of splenic abscesses.
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