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Splenic rupture, liquefaction and infection after blunt abdominal trauma

A 48-year-old man with no significant medical history presented with increasing abdominal pain for the past week with new fever and chills overnight. The patient suffered a mechanical fall 2 weeks prior to presentation, striking his left flank on a stepping stool from standing but did not seek medical attention due to tolerable discomfort. His laboratory values were significant for leucocytosis (19 10^9/L) and lactic acidosis (3 mmol/L). The patient’s haemoglobin and haematocrit were within normal limits (14.1 gm/L and 42.9%, respectively). On physical examination, the patient had a soft abdomen with diffuse tenderness (greatest in the left upper quadrant), but no costovertebral or flank tenderness, external signs of trauma or ecchymosis. A CT with intravenous contrast was obtained with non-enhancement of the lower pole of the spleen with an irregular margin related …