• Gavish K Awotar, Fuwen Luo, Zhengdong Zhao, Guoxin Guan, Shili Ning, Jinshuai Ren, Yaqing Liu, Guangzhi Wang, and Pixu Liu.
• Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, 116023, P.R. China The First Affiliated Hospital Collaborative Innovation Center of Oncology-Institute of Cancer Stem Cell, Dalian Medical University, Dalian City, Liaoning Province, P.R. China.
• Medicine (Baltimore). 2016 Sep 1; 95 (38): e4941e4941.

BackgroundThe cancer of the splenic flexure of the colon is a rare medical entity with severe morbidity because of its insidious onset.MethodsWe present the case of a 59-year-old male patient with dull left upper quadrant pain, leukocytosis, and anemia. A splenic abscess described as an air-fluid level with splenocolic fistula was found on CT scan imaging. Surgery was done for splenic pus drainage. He was again admitted 2 months later for intestinal obstruction.ResultsAn exploratory laparotomy showed multiple hard, gray liver nodules as well as a hard mass in the small bowel. Owing to extensive adhesions and a late stage of cancer involvement, the splenic flexure tumor was not resected. A loop transverse colostomy was done and a Coloplast Colostomy bag placed. We also reviewed the literature-linking colon cancer and splenic abscess with specific attention to the carcinoma of the splenic flexure. As the latter invades through the spleen matter, there is the creation of a splenocolic fistula, which allows the migration of normal gut flora into the spleen. This leads to the formation of the splenic abscess.ConclusionThis is the 13 case report pertaining to invading colonic cancer causing a splenic abscess. Although the treatment for splenic abscesses is shifting from splenectomy to image-guided percutaneous pus drainage, the few reported cases make the proper management of such complication still unclear.

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