Abstract
We report the case of a patient who developed splenic infarction after surgery for transverse colon cancer, which was successfully treated by conservative therapy. A 57-year-old woman visited our emergency room complaining of fever and abdominal pain. A plain CT of the abdomen showed thickening of the wall of the transverse colon, with retroperitoneal gas and fluid collection. The patient was diagnosed as having an intramesenteric abscess secondary to cancerous penetration of the transverse colon, and emergency surgery was performed. Since the splenic flexure of the colon was located posterior to the fundus of the stomach, the gastrosplenic ligament was divided during the colonic mobilization. Left hemicolectomy and drainage of the intramesenteric abscess were performed. Abdominal enhanced CT on postoperative day 9 showed low-density fluid and a small gas bubble in the spleen. A diagnosis of splenic infarction was made and the patient was started on conservative treatment with antibiotics and drainage. She recovered well and was discharged on postoperative day 67. Abdominal enhanced CT at 6 months after the surgery showed complete disappearance of the spleen. Conservative therapy for splenic infarction may be the treatment strategy of choice in patients whose clinical condition is stable, if effective drainage can be performed.
