Unusual Case of Acute Abdomen in a Patient on Maintenance Hemodialysis

Abstract

Acute abdominal pain is not a frequent presentation in the emergency department in patients on maintenance hemodialysis (HD). Common causes of acute abdomen in these patients are bowel infarction, pancreatitis, and peritonitis. Splenic infarction presenting as acute abdomen is a rare entity. We report a case where a 38-year-old female on HD presented with acute abdomen and was found to have splenic infarction. On further evaluation, she was found to have infective endocarditis of the aortic valve as a complication of catheter-related bloodstream infection due to nontunneled catheter. The management of the patient comprised of prompt removal of catheter and intravenous antibiotics.