Ga-67 uptake in a perisplenic fluid collection: planar and SPECT images
Challa, S.; Milne, N.; Brown, T.W.; Lyons, K.P.
Clinical Nuclear Medicine 22(12): 870-872
1997
ISSN/ISBN: 0363-9762 PMID: 9408663 Document Number: 475897
A 49-year-old man with alcoholic liver disease and insulin dependent diabetes was admitted for left-sided abdominal pain, fever, chills, and leukocytosis. An ultrasound showed hepatosplenomegaly and bilateral pleural effusions. A Tc-99m sulfur colloid scan revealed marked reticulo-endothelial shift to the spleen with multiple wedge shaped photopenic areas representing either infarcts, abscesses, lymphoma, or metastatic cancer. Four days later, a whole-body Ga-67 scan with SPECT showed a perisplenic collection of tracer. A diagnosis of probable perisplenic infection was made. A CT of the abdomen showed a perisplenic fluid collection. The working diagnosis was splenic rupture from splenic infarcts complicated by infection of the perisplenic fluid or hematoma. A second CT scan of the abdomen after a week of antibiotics showed a decrease in the perisplenic fluid collection. The patient was asymptomatic and afebrile at the time of discharge.