Thoracic Empyema Revealing a Fistulized Splenic Abscess: A Rare Case

Subphrenic abscesses, like the splenic abscess, is a collection of infectious origin. It is rare and potentially severe due to local complications. Its diagnosis is difficult given the variable clinical symptomatology. The abdominal computed tomography poses the diagnosis with certainty. It requires emergency medical and surgical treatment. We report the case of a patient with a splenic abscess discovered fortuitously following the radiological exploration of thoracic empyema. The surgical procedure consisted of a total splenectomy with suture of the diaphragmatic fistula and chest drainage of the empyema. The postoperative suites were favourable after 2-year of follow-up.

The splenic abscess is a cause of thoracic empyema and its rupture through a diaphragmatic breach remains a rare etiology, requiring emergency medical and surgical management.