PMC10196135_01
Contrast-enhanced abdominal CT scan. (A): Multiple low-density lesions of the spleen. (B): The largest lesion measures 45 x 55 mm.
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F1
Abdominal contrast-enhanced computed tomography (CT) indicated multiple low-density lesions of the spleen (Figure 1A). The enhanced scan showed annular enhancement, with the largest being 45 x 55 mm (Figure 1B).
WBC, NE and NE% decreased after antibiotic treatment, increased slightly on the first postoperative day, and then continued to decline to the normal values. CRP continued to decrease after various interventions. These trends demonstrate that our treatment was effective. HGB continued to decline on admission, rebounded after we administered a blood transfusion, and was slightly low after surgery.
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F2
After 3 days of cefminox treatment, WBC, NE%, NE and CRP decreased (Figure 2).
Contrast-enhanced MRI. (A): Splenomegaly with up to 7 abscesses in the same axial plane. (B): The largest abscesses.
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F3
MRI of the upper abdomen revealed splenomegaly with multiple abscesses and slight perisplenic exudation (Figures 3A,B).
Intraoperative images and histopathology. (A): The spleen was enlarged (15 x 12 x 8 cm), and its surface was uneven and partially white. (B): Pus coming out of the spleen. (C): Chronic suppurative splenic inflammation with focal necrosis, abscess formation, local histiocytic hyperplasia, blood sinus dilatation and hemorrhage, and interstitial fibrous tissue hyperplasia.
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The surface of the spleen was uneven and partially white (Figure 4A), and the spleen was closely adhered to the greater omentum and liver, with edema. Postoperative pathological findings included chronic suppurative splenic inflammation with focal necrosis, abscess formation, local histiocytic hyperplasia, blood sinus dilatation and hemorrhage, and interstitial fibrous tissue hyperplasia (Figure 4C).