Peritonitis due to Ruptured Splenic Abscess Managed by Trans-gastric Endoscopic Ultrasonography-guided Dual Drainage Combined with Lavage and Intermittent Negative Pressure: A Case Report and Literature Review.
{"title":"Peritonitis due to Ruptured Splenic Abscess Managed by Trans-gastric Endoscopic Ultrasonography-guided Dual Drainage Combined with Lavage and Intermittent Negative Pressure: A Case Report and Literature Review.","authors":"Tesshin Ban, Yoshimasa Kubota, Naoto Imura, Shun Sasoh, Satoshi Tanida, Makoto Nakamura, Tomoaki Ando, Takashi Joh","doi":"10.2169/internalmedicine.5773-25","DOIUrl":null,"url":null,"abstract":"<p><p>There are no established guidelines for managing patients with rare but fatal ruptured splenic abscesses. In this clinical scenario, open splenectomy seems to be a standard literature-based intervention. However, open splenectomy under general anesthesia is not a priority in high-risk surgical patients. We herein report an endoscopic ultrasound-guided transmural dual drainage combined with lavage and intermittent negative pressure drainage as an alternative to surgery for a critical patient with a ruptured splenic abscess and discuss the benefits and drawbacks of open splenectomy as a case report and literature review.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Internal medicine (Tokyo, Japan)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2169/internalmedicine.5773-25","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
There are no established guidelines for managing patients with rare but fatal ruptured splenic abscesses. In this clinical scenario, open splenectomy seems to be a standard literature-based intervention. However, open splenectomy under general anesthesia is not a priority in high-risk surgical patients. We herein report an endoscopic ultrasound-guided transmural dual drainage combined with lavage and intermittent negative pressure drainage as an alternative to surgery for a critical patient with a ruptured splenic abscess and discuss the benefits and drawbacks of open splenectomy as a case report and literature review.