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Journal of Medical Case Reports

, 3:9

First Online: 13 January 2009Received: 28 December 2007Accepted: 13 January 2009DOI: 10.1186-1752-1947-3-9

Cite this article as: Murphy, K., Chaudry, M. & Redmond, H. J Med Case Reports 2009 3: 9. doi:10.1186-1752-1947-3-9


IntroductionThe case report describes the rare presentation of a 79-year-old patient with a locally perforated splenic flexure tumour of the colon presenting with an apparent empyema thoracis in the absence of abdominal signs or symptoms.

Case presentationInitial presentation was with a non-productive cough, anorexia and general malaise. An admission chest X-ray and subsequent computed tomographic image of the thorax showed a loculated pleural effusion consistent with an empyema. The computed tomography also showed a thickened splenic flexure. Thoracotomy was performed and a defect in the diaphragm was revealed after the abscess had been evacuated. A laparotomy was carried out at which point a tumour of the splenic flexure of the colon was found to be invading the spleen and locally perforated with subsequent collection in communication with the thorax. The tumour and spleen were resected and a transverse end colostomy was fashioned.

ConclusionOne must consider the diagnosis of pathology inferior to the diaphragm when an apparent empyema thoracis is encountered even in the absence of clinical signs or symptoms.

Electronic supplementary materialThe online version of this article doi:10.1186-1752-1947-3-9 contains supplementary material, which is available to authorized users.

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Author: K Murphy - M Chaudry - HP Redmond

Source: https://link.springer.com/

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