Splenic abscess

Abstract

We present 7 cases of splenic abscess collected in our hospital from 1980 to 1988 as well as a review of 227 cases of the world literature. The signs and symptoms are nonspecific in all of them, fever being the most constant. Computed tomography scan followed by sonography were demonstrated to be the best methods of diagnosis. The treatment carried out on all of our patients was splenectomy followed by antibiotic coverage. Two of them died 15 days after the operation due to persistence of the septic state. In our review of the literature, we observe a rise in the population at risk for splenic abscess due to an increase in the use of immunosuppressive agents, to the higher survival of leukemic patients, and to the great incidence of drug abuse among others. Nevertheless, the advances in the use of sonography and computed tomography scan have made possible a more accurate diagnosis, therefore making possible an earlier treatment and a better prognosis. We believe that the treatment of choice is splenectomy with conservative treatment used only in specific cases where surgery represents a high risk for the patient.

Splenic Abscess

“…Splenectomy remains the treatment of choice for splenic abscess [2, 3, 12, 20, 21, 22, 23, 24]. Percutaneous drainage seems to be an alternative but is ineffective in practice.…”

“…Endocarditis or another distant site of infection accounted for more than two thirds of all the cases [3, 4, 5, 6]. However, epidemological data appear to be changing over the years and varying among countries.…”

“…Gram-positive organisms predominate. Aerobic germs are isolated more frequently [3]. Polymicrobial flora with splenic abscesses is seen recently in increasing numbers.…”

“…Autopsy studies have shown the incidence of splenic abscess to be between 0.14 and 0.7% [1, 2]. Current sophisticated imaging techniques and increasing awareness have contributed to early diagnosis and management of splenic abscess with acceptable morbidity and mortality [1, 2, 3, 4, 5, 6]. …”

Splenic abscess in a patient with fecal peritonitis

“…The incidence of septic complications, such as abscess formation, in fecal peritonitis due to colon perforation has been reported in various organs [1,2] . The spleen is one of the least involved organs especially in non-diabetic and non-immunosuppressed patients [3,4] .…”