Non-traumatic ruptured splenic abscess presenting with pneumoperitoneum in an immunocompetent patient: a diagnostic dilemma.

Splenic abscess is a rare life-threatening clinical entity. There are only a handful of reported cases of spontaneous splenic abscess rupture with pneumoperitoneum. Rupture of splenic abscess associated with gas-producing pathogens may lead to pneumoperitoneum. We hereby report the case of a ruptured splenic abscess with pneumoperitoneum in a young immunocompetent woman masquerading as hollow viscus perforation peritonitis. Ruptured splenic abscess should be kept in mind for treating surgeons as a differential diagnosis of pneumoperitoneum or peritonitis, particularly for immunocompromised patients. © BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.