Sandbox:splenic abscess
Overview
Splenic abscess is an uncommon and lifethreatening condition.
Classification
- Unilocular abscess
- Bilocular abscess
- Solitary abscess
- Multiple abscesses
Pathophysiology
Splenic abscess can result from various sources such as
- Splenic trauma or splenic laceration
- Hematogenous spread of bacteria
- Contiguous spread of bacteria
Risk Factors
Common risk factors of splenic abscess include:[1]
- Diabetes mellitus
- Immunocompromised conditions such as AIDS[2]
- Tunerculosis
- Concomitant liver disease such as cirrhosis
- Malignancies
Epidemiology and Demographics
Incidence
Indceidence of spelenic abscess varies between 0.1% to 0.7%.[3][4]
Case Fatality Rate
Splenic abscesses are associate with increased morbidity and mortality.
Diagnosis
History and Symptoms
Major symptoms of splenic abscess include:
- Fever
- Abdominal pain
- Nausea and vomiting
Physical Examination Findings
Abdominal Examination
- Tender splenomegaly
As the clinical features of splenic absecess are non specific and vague such as abdominal pain, fever and vomiting, that makes diagnosis is challenging and relied on imaging modalities. Imaging studies such as ultrasound, computerized tomography made the diagnosis early and more accurate that reduces morbidity and mortality.[5]
Laboratory Tests
Blood Tests
- CBC with differential
- Erythrocyte sedimentation ratio (ESR)
Treatment
Antimicrobial Regimen
Percutaneous Drainage
- First line of treatment for splenic abscess
- Safe and effective than surgery in both unilocular and bilocular abscesses.
- Preserves spleen
Open Drainage
Surgery
- Definitive treatment for splenic abscess
References
- ↑ Sreekar H, Saraf V, Pangi AC, Sreeharsha H, Reddy R, Kamat G (2011). "A retrospective study of 75 cases of splenic abscess". Indian J Surg. 73 (6): 398–402. doi:10.1007/s12262-011-0370-y. PMC 3236272. PMID 23204694.
- ↑ Simson JN (1980). "Solitary abscess of the spleen". Br J Surg. 67 (2): 106–10. PMID 7362937.
- ↑ Chun CH, Raff MJ, Contreras L, Varghese R, Waterman N, Daffner R; et al. (1980). "Splenic abscess". Medicine (Baltimore). 59 (1): 50–65. PMID 6986009.
- ↑ Gadacz TR (1985). "Splenic abscess". World J Surg. 9 (3): 410–5. PMID 3892934.
- ↑ Thanos L, Dailiana T, Papaioannou G, Nikita A, Koutrouvelis H, Kelekis DA (2002). "Percutaneous CT-guided drainage of splenic abscess". AJR Am J Roentgenol. 179 (3): 629–32. doi:10.2214/ajr.179.3.1790629. PMID 12185032.