Pneumoperitoneum secondary to a ruptured splenic abscess.

A splenic abscess is a clinical rarity. Approximately 600 cases have been described in the current literature, mostly solitary case reports and small patient series. While several cases have been described with gas formation in a splenic abscess or rupture of an air-containing abscess, visible on a plain X-ray study as free air or bubbles in the left upper quadrant [1], it is rare for the patient to present with only free air under the right hemidiaphragm, as seen classically in perforation of a hollow viscus.