Splenic Abscess

Abstract

Background/Aims: To study the demographics, signs and symptoms, causes, risk factors, imaging findings, bacteriologic profile, treatment and outcome of patients with splenic abscess. Method: The medical records of 17 patients with splenic abscess at two tertiary-care hospitals between 1989 and 1997 were retrospectively reviewed. The demographic data, physical and radiological findings, treatment, bacteriology reports and outcome of treatment were reviewed. Results: The mean age of patients was 43 years (range 7–79 years). Fever and abdominal pain were the most prominent signs. Seven patients were immunocompromised, three had abscessed hydatic cysts, two were drug users and three suffered from splenic trauma, infarction, and endocarditis, respectively. No predisposing factor was identified in 2 patients. In all cases, CT demonstrated the splenic lesion(s). Staphylococcus species and Bacteriodes were the most common microbes, identified in the blood and abscess cultures. Thirteen patients underwent splenectomy, two medical therapy and two no therapy with respective survival rates of 92, 100 and 0%. Conclusion: Splenic abscess is a rare surgical entity encountered mostly in immunocompromised patients. CT scan is the gold standard for the definite diagnosis. Splenectomy is the treatment of choice, while medical therapy should be reserved for unusual pathogens provided that an effective antimicrobial agent is available.

Splenic Abscess after Sleeve Gastrectomy: A Report of Two Cases

“…It occurs due to bacteremic seeding of a previously infarcted area or by direct seeding of the spleen from an adjacent infectious process. Predisposing conditions for primary abscesses include diabetes mellitus, malignancy, polycythemia vera, endocarditis, previous trauma, sickle cell disease, urinary tract infection, intravenous drug abuse, AIDS, and other immune-compromised conditions [3,4,5]. It has been seldom reported following gastric surgery including Nissen fundoplication and gastrectomy for cancer [6].…”

“…The common signs and symptoms of splenic abscess are nonspecific. CT scan remains the gold standard for definitive diagnosis [5], but ultrasound can effectively demonstrate many of the characteristics of splenic abscess. Both of these imaging studies have a sensitivity of 98% [10,11].…”

Isolated splenic abscess in brucellosis

“…Organisms associated with splenic abscess include [9]: (i) aerobes—Gram-positive cocci (Streptococcus, Staphylococcus and Enterococcus); Gram-negative bacilli ( Klebsiella pneumoniae , Escherichia coli , Pseudomonas, Proteus and Salmonella). (ii) Anaerobes—Peptostreptococcus, Bacteroides, Fusobacterium, Clostridium and Propionibacterium acnes .…”

Splenic Abscesses Caused by a Reptile-Associated <i>Salmonella</i> Infection

“…When the diagnosis is considered, the best way to confirm is supplementary imaging (ultrasound, CT, or MRI). At present, splenectomy is the gold standard for treatment [5,6,7]. But ultrasound- or CT-assisted draining is an increasingly accepted method of treatment, especially in the presence of an isolated abscess [7, 8].…”