Splenic abscess is unusual. Population-bases autopsy studies have established the incidence of splenic abscess at between 0.2 to 0.7 percent. Currently, with the common use of computed tomography, the early diagnosis and selective nonopertive
treatment
of splenic abscess have evolved.
The author analized the clinical records of the 6 splenic abscess patients who were diagnosed and treated t the Dept. of Surgery, Kuro Hospital during 9 years from Jan. 1984 to Dec. 1992.
@ES The results were follows:
@EN Six patients, five men and one woman, between the ages of 24 and 59 years were included in this review. All patients had one or more associated predisposing conditions, which were pulmonary Tb, thrombocytosis, previous celiotomy, chronic
pancreatitis, gastric ulcer, typhoid fever and spontaneous abortion. Fever (5/6) was the most common clinical feature and left upper quadrant pain (4/6), nausea and vomiting (2/6) were followed. Leukocytosis (4/6) and abnormal finding of chest
radiographs (5/6), ultrasonographs (4/6) and CT scans (2/2) were noted. Staphylococcus aureus (2/6), Escherichia coli (1/6), Enterobacter cloacae (1/6) and Peptostreptococcus (1/6) were cultured. Five patients were treated with splenectomy and
one
patient was treated with sono-guided percutaneous drainage but the catheter was dislodged accidentally at the 12th day. Postoperative complications were left pleural effusion in three cases.
In summary, splenic abscess is suspected when male patients have high fever, left upper quadrant pain, leukocytosis and abnormal chest radiographs. Although splenectomy and appropriate antibiotics remain the traditional method method of
treatment,
our
review and the recent literature suggest percutancous drainage is indicated for a select group of patients.
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