Abscesses of the spleen: report of three cases

• Published in: World journal of gastroenterology : WJG Vol. 14; no. 19; pp. 3088 - 3091
• Main Authors: Fotiadis, Constantin, Lavranos, Giagkos, Patapis, Pavlos, Karatzas, Gabriel
• Format: Journal Article
• Language: English
• Published: United States rd Department of Surgery, Attikon University Hospital, Chaidari 12462, Greece 21.05.2008; The WJG Press and Baishideng
• Subjects: Abscess - microbiology; Abscess - pathology; Abscess - surgery; Adult; Case Report; Female; Humans; Male; Middle Aged; Splenectomy; Splenic Diseases - microbiology; Splenic Diseases - pathology; Splenic Diseases - surgery; Staphylococcal Infections - complications; Staphylococcal Infections - microbiology; Staphylococcal Infections - pathology; Staphylococcal Infections - surgery; Streptococcal Infections - complications; Streptococcal Infections - microbiology; Streptococcal Infections - pathology; Streptococcal Infections - surgery; Tomography, X-Ray Computed; Treatment Outcome; Spleen; Splenectomy; Infections; Trauma; Abscess
• ISSN: 1007-9327
• DOI: 10.3748/wjg.14.3088

Abscess of the spleen is a rare discovery, with about 600 cases in the international literature so far. Although it may have various causes, it is most usually associated with trauma and infections of the spleen. The latter are more common in the presence of a different primary site of infection, especially endocarditis or in cases of ischemic infarcts that are secondarily infected. Moreover, immunosuppression is a major risk factor. Clinical examination usually reveals a combination of fever, left-upper-quadrant abdominal pain and vomiting. Laboratory findings are not constant. Imaging is a necessary tool for establishing the diagnosis, with a choice between ultrasound and computed tomography. Treatment includes conservative measures, and surgical intervention. In children and in cases of solitary abscesses with a thick wall, percutaneous catheter drainage may be attempted. Otherwise, splenectomy is the preferred approach in most centers. Here, we present three cases of splenic abscess. In all three, splenectomy was performed, followed by rapid clinical improvement. These cases emphasize that current understanding of spleen abscess etiology is still limited, and a study for additional risk factors may be necessary.