With less than 1000 cases described globally, abscess of the spleen constitutes an infrequent disease. Difficult to diagnose, the disease carries a high morbidity and mortality rate when it remains undiagnosed, since it has a predisposition for immunocompromised patients. Furthermore, with the advent of non-operative management of splenic trauma, less splenectomies are performed using embolization, potentially giving rise to the formation of a splenic abscess. Therefore, it is important that surgeons are familiar with this disease and treat it accordingly. The aim of this article is to review the pathogenesis, epidemiology, diagnostic modalities and methods of treatment for this disease. Different imaging modalities facilitate diagnosis, with computed tomography being the cornerstone. Splenectomy remains the mainstay of treatment, although encouraging results of more conservative methods have been reported. Splenic abscess is relevant to the differential diagnosis of febrile surgical disease and should be suspected when the surgeon is confronted with patients complaining of fever and pain in the left subcostal region, especially when they are under some form of immunosuppression.
PathophysiologyFungal splenic abscesses are multiloculated in 90%
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