A colon cancer at the splenic flexure may be associated with a splenic abscess. The diagnosis of colon cancer may be delayed if the surgeon focuses only on the splenic abscess.
Clinical features:
(1) left upper quadrant pain
(2) leukocytosis
(3) splenic abscess with an air-fluid level
(4) evidence of a splenocolic fistula
(5) presence of a colon cancer at the splenic flexure
(6) variable gas in the portal vein
(7) variable thrombosis of the splenic or portal vein
Cultures of abscess fluid may be polymicrobic with enteric pathogens.
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