An unusual presentation of a splenic abscess as a paraumbilical sinus

Authors:I N Akinwunmi, R A Akinola, O T Ajai, G O G Awosanya, R I Osuoji, M Erinoso, O H Elebute, M A Bankole
Int J Biol Med Res. 2011; 2(1): 450 – 452  |  PDF File

Abstract

A 12 year old boy with Hb genotype SC, was referred to the pediatric department of Lagos State University Teaching hospital (LASUTH) on account of progressive abdominal swelling, low grade fever, yellow eyes and pain in the left upper arm. Clinical examination revealed a paraumbilical sinus, hepatomegaly and ascites which were confirmed by ultrasound but the spleen was not visualized. A healing ulcer at the lateral aspect of the lower part of the left leg was also noted. Liver function tests and other laboratory tests were normal except the PCV which portrayed anaemia. A sinogram done suggested an entero-cutaneous fistula. Subsequent fistulectomy showed adhesions, a fistulous tract from a splenic collection to the umbilicus within which the spleen was found floating, confirming a splenic abscess with a fistulous connection to the skin.