Needle in a haystack: a case report of splenic foreign body-associated sepsis. Issue 11 (29th November 2021)

• Record Type: Journal Article
• Authors: Turner, Benedict R H; Barnacle, James; Sheth, Hemant
• Is Part Of: Journal of surgical case reports. Volume 2021:Issue 11(2021)
• Publication Date: 2021-11-29
• Subjects: Surgery -- Periodicals; Surgery -- Case studies -- Periodicals; 617.005
• DOI: 10.1093/jscr/rjab525
• Languages: English
• ISSNs: 2042-8812

Abstract

Abstract: Instances of foreign bodies impacted in solid organs are rare, and rarer still are reports of objects in the spleen. A 42-year-old presented septic with abdominal pain, high inflammatory markers and haemodynamic instability. She was found to have a splenic haematoma and a 4-cm hyperdense foreign body within the spleen. Ultrasound-guided drainage of the haematoma isolated Streptococcus anginosus and conservative management with intravenous antibiotics avoided the need for emergency splenectomy. The bacterium isolated was the same cultured 9 months previously from the patient's empyema fluid. The origin of the foreign body was not identified, though is made of metal and pre-dates any hospital admissions. The case raised the question of how an object might penetrate the spleen without knowledge of the patient and highlighted the risks of foreign body-associated sepsis, the risks and benefits of emergency splenectomy and management of complex cases with paucity of evidence.