Splenic Abscess: A Single Institution Study and Review of the Literature

Abstract

PurposeThe aim of this study was to review our experience with splenic abscesses, with respect to the relevant aspects of splenic abscesses and treatment outcomes.Materials and MethodsWe reviewed the cases of 18 patients who had splenic abscesses and who were treated at our hospital from November 1993 to December 2008.ResultsThe most common symptom at presentation was abdominal pain in 12 patients (66.7%). The median duration from symptom onset until establishment of a diagnosis was 22 days. Streptococcus viridians was the most common pathogen (27.8%), follow by Klebsiella pneumoniae (22.2%). The mortality rate during the inpatient period and the previous 90 days was 16.6%. Three of four patients with Klebsiella pneumoniae showed a single abscess pocket. Four patients (22.2%) underwent percutaneous drainage, eight (44.5%) recieved antibiotic treatment only and six (33.3%) underwent splenectomy.ConclusionThere is no gold standard for treating splenic abscesses. Treatment should be customized for each patient.

Uncommon cause of pneumoperitoneum

“…Futhermore, blood cultures remained negative in our case. This appears to be the case in approximately 30% of patients with a splenic abscess [4,5] .…”

“…Colon carcinoma are also important precursors in the small number of cases in which metastasis of the spleen were secondary infected [15] . Other haematological spread can be caused by retropharyngeal abscess, otitis media, tonsillectomy, infective endocarditis and phlebitis of the calf [3,5,16] . The most common organisms found on bacteriological examination are Gram Negative Bacillus (Klebsiella Pneumoniae, Escherichia Coli) and Gram Positive Coccus (Staphylococcus Aureus), although a great variety of pathogens have been described [4,17,18] .…”

“…Presenting symptoms include upper abdominal pain, recurrent or persistent fever, nausea and vomiting, splenomegaly, leukocytosis and left lower chest abnormalities [4,5] . Diagnosis of a splenic abscess is confirmed on ultrasound or computed tomography (CT)-imaging of the abdomen.…”

Unusual complication of multiple splenic abscesses arising from a feeding jejunostomy tube subsequent to total gastrectomy: A case report and literature review

“…The most probable cause of the formation of these post-operative abscesses may be the insufficient perfusion and ischemia of the pole of the spleen due to the ligation of the short gastric vessels (SGVs) during the procedures (15,16). Common clinical manifestations of splenic abscesses exhibited by patients include chills, fever, upper left-side abdominal pain, and leukocytosis (9,11,13,18). Other symptoms include nausea and vomiting or a left pleural effusion (9,13,18).…”

“…Common clinical manifestations of splenic abscesses exhibited by patients include chills, fever, upper left-side abdominal pain, and leukocytosis (9,11,13,18). Other symptoms include nausea and vomiting or a left pleural effusion (9,13,18). However, due to the nonspecific nature of the symptoms and signs developed from splenic abscess, the diagnosis of abscess has frequently been delayed in the past and the incidence of morbidity and mortality was occasionally high (9).…”