Abstract
There are no established guidelines for managing patients with rare but fatal ruptured splenic abscesses. In this clinical scenario, open splenectomy seems to be a standard literature-based intervention. However, open splenectomy under general anesthesia is not a priority in high-risk surgical patients. We herein report an endoscopic ultrasound-guided transmural dual drainage combined with lavage and intermittent negative pressure drainage as an alternative to surgery for a critical patient with a ruptured splenic abscess and discuss the benefits and drawbacks of open splenectomy as a case report and literature review.