Infarction and splenic abscess as the cause of acute abdomen in a patient with myelomonocytic leukemia

Authors

  • José Luis Beristain-Hernández <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Servicio de Cirug&iacute;a General, Departamento de Cirug&iacute;a Hepatobiliar y Pancre&aacute;tica. Ciudad de M&eacute;xico, M&eacute;xico.</p> http://orcid.org/0000-0002-7628-2177
  • Arni Alejandro Mendoza-Soto <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Servicio de Cirug&iacute;a General, Departamento de Cirug&iacute;a Hepatobiliar y Pancre&aacute;tica. Ciudad de M&eacute;xico, M&eacute;xico.</p> http://orcid.org/0009-0004-0812-9658
  • Jessica Jaime-Silva <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Servicio de Cirug&iacute;a General, Departamento de Cirug&iacute;a Hepatobiliar y Pancre&aacute;tica. Ciudad de M&eacute;xico, M&eacute;xico.</p> http://orcid.org/0000-0002-9337-927X
  • Lino Enrique Ramírez-Sosa <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Servicio de Cirug&iacute;a General, Departamento de Cirug&iacute;a Hepatobiliar y Pancre&aacute;tica. Ciudad de M&eacute;xico, M&eacute;xico.</p> http://orcid.org/0000-0003-0717-0339

DOI:

https://doi.org/10.5281/zenodo.10999019

Keywords:

Chronic Myeloid Leukemia, Splenic Infarction, Splenic Abscess

Abstract

Background: Splenic infarction is a rare cause of acute abdomen. The two main causes are thromboembolic diseases and infiltrative hematological disorders. The splenic abscess is the result of a hematogenous seeding, whose causes are trauma, splenic artery embolization, endocarditis, and immunocompromised states.

Clinical case: 48-year-old male patient with a history of chronic myelomonocytic leukemia on mercaptopurine-based treatment, who presented intermittent asthenia, adynamia, and abdominal distension for 2 months; a computed tomography of the abdomen with intravenous contrast was performed, reporting areas of infarction and an image suggestive of a splenic abscess in the upper pole, for which an open splenectomy was performed with adequate clinical evolution. A documentary review of the disease and of the therapeutic options was carried out, with an emphasis on surgical management.

Conclusion: The main cause of morbidity and mortality in the case presented was splenic infarction, which is aggravated by the presence of hematological diseases; therefore, the identification of those patients at risk of complications will allow in a timely manner a diagnostic and therapeutic approach, and the detection of those who require urgent surgical management.

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Author Biographies

  • José Luis Beristain-Hernández, <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Servicio de Cirug&iacute;a General, Departamento de Cirug&iacute;a Hepatobiliar y Pancre&aacute;tica. Ciudad de M&eacute;xico, M&eacute;xico.</p>

    Departamento de Cirugía Hepatobiliar. Servicio de Cirugía General.

     

  • Arni Alejandro Mendoza-Soto, <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Servicio de Cirug&iacute;a General, Departamento de Cirug&iacute;a Hepatobiliar y Pancre&aacute;tica. Ciudad de M&eacute;xico, M&eacute;xico.</p>

    Departamento de Cirugía Hepatobiliar. Servicio de Cirugía General.

     

  • Jessica Jaime-Silva, <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Servicio de Cirug&iacute;a General, Departamento de Cirug&iacute;a Hepatobiliar y Pancre&aacute;tica. Ciudad de M&eacute;xico, M&eacute;xico.</p>

    Departamento de Cirugía Hepatobiliar. Servicio de Cirugía General.

     

  • Lino Enrique Ramírez-Sosa, <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Servicio de Cirug&iacute;a General, Departamento de Cirug&iacute;a Hepatobiliar y Pancre&aacute;tica. Ciudad de M&eacute;xico, M&eacute;xico.</p>

    Departamento de Cirugía Hepatobiliar. Servicio de Cirugía General.

     

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Published

2024-05-03

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Section

Clinical Cases