Description
We describe a case of ulcerative pan-colitis and primary sclerosing cholangitis complicated by fatal pneumococcal meningitis. At post-mortem the patient was found to have profound splenic atrophy. We review the literature on hyposplenism in inflammatory bowel disease and conclude that those patients with pan-colitis in ulcerative colitis and colonic involvement in Crohn’s should have splenic function assessed, with ultrasound scan and pitted red cell count. Those found to be hyposplenic should be offered vaccination against encapsulated organisms. Co-morbid or isolated primary sclerosing cholangitis with hyposplenism has not been described previously in the literature; its significance as a factor in the development of hyposplenism therefore remains uncertain.
