Splenic abscess: Presentation, treatment options, and results

Faught, William E.; Gilbertson, Jeffrey J.; Nelson, Edward William

doi:10.1016/0002-9610(89)90205-5

Cited by 67 publications

(45 citation statements)

References 12 publications

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“…The radiologic and diagnostic study of preference for splenic abscesses is an abdominal examination by CT scans [15]. CT scans can characterise the contents of the abscess cavity and also reveal the uni/multilocularity of the abscesses.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Study of 75 Cases of Splenic Abscess

et al. 2011

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Splenic abscess is an uncommon and lifethreatening condition. Due to its nonspecific clinical picture, it remains a diagnostic challenge. Multiple radiological modalities are used for the diagnosis. In this retrospective study we analyzed 75 patients treated between 1999 and 2009. The patients were divided into three groups depending on the treatment received. Group I (n=14) consisted of patients treated with only antibiotics, Group II (n=19) patients were treated with percutaneous drainage and Group III (n=42) with splenectomy. We tried to establish epidemiologic and clinical features and therapeutic options in splenic abscess. Our study suggests that percutaneous drainage is a safe and effective alternative to surgery especially in unilocular or bilocular abscesses thus allowing preservation of the spleen. It should be considered as the first line of treatment although splenectomy remains the final definitive procedure if percutaneous drainage fails.

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Section: Discussionmentioning

confidence: 99%

A Retrospective Study of 75 Cases of Splenic Abscess

et al. 2011

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“…However, this study was reported prior to the routine use of ultrasound and CT scan. Faught et al [6] have reported correct preoperative diagnosis in nine out of ten cases employing the latest imaging methods. They reported the mean period from first symptom to diagnosis as 12 days.…”

Section: Discussionmentioning

confidence: 99%

“…Common causes of splenic abscess reported [1,6,8] include hematogenous spread from subacute bacterial endocarditis and contiguous spread of infection from an adjacent focus-like colon, pancreas, or kidney. Infections of splenic hematomas following trauma and infarcts as in sickle cell anemia and immunodeficiency states account for most of the remaining cases.…”

Section: Discussionmentioning

confidence: 99%

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Splenic Abscess: Presentation, Diagnosis and Management

1992

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Splenic abscess is infrequently encountered. This paper reports on the diagnosis and management of six cases from Southern Saudi Arabia. Common presenting features were diffuse abdominal pain and fever. Signs localized to left upper quadrant of the abdomen were present in only two patients. The difficulty of diagnosis is signified by the fact that two cases were overlooked during initial surgery. The computed tomographic (CT) scan was quite accurate in three cases while ultrasound was reliable in five patients. Known causes of splenic abscess were present in four of the six patients. Two patients had gangrenous bowel and one each had bacterial endocarditis and sickle cell trait. All patients were managed by perioperative antibiotics and splenectomy. Review of the literature shows that splenectomy remains the treatment of choice while CT-guided aspiration is being increasingly employed especially for the poor-risk patients with unilocular abscesses.MA Cheema, AA Al-Saigh, ABA Latif, Splenic Abscess: Presentation, Diagnosis and Management. 1992; 12(6): 552-554 The clinical presentation of splenic abscess may be difficult to recognize because the condition is uncommon. A majority of patients present with diffuse abdominal pain sometimes related to the left upper quadrant of the abdomen and have pyrexia. Clinical suspicion of splenic abscess can be confirmed by an ultrasound examination or more precisely by an abdominal computed tomographic (CT) scan. When left untreated, the splenic abscess becomes fatal [1] and its early detection can result in prompt treatment usually by splenectomy or percutaneous drainage. We report six patients with splenic abscess which presented over a period of four years.We also present a review of literature in order to familiarize clinicians of the usual methods of presentation of the patients with splenic abscess in the hope that a high index of suspicion will result in early diagnosis and timely treatment of these patients. Patients, Methods and ResultsDuring August 1987 to April 1991, six patients were treated for splenic abscess by splenectomy in Asir Central Hospital. Their presenting features, predisposing factors, difficulties in diagnosis and management are presented in the following case reports. Patient 1A 32-year-old Saudi female presented with fever, rigors, vomiting, hematuria, and left hypochondrial pain for seven days. She had a normal delivery six weeks prior to admission. The patient was not a known diabetic. On examination, her temperature was 39.8°C and abdomen showed a tender enlarged liver and spleen.

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“…Although splenectomy has been advocated as the treatment of choice for splenic abscess, certain patients may be treated successfully with appropriate antibiotics and ultrasound guided simple drainage, preserving spleen [3].…”

Section: Introductionmentioning

confidence: 99%