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Splenic abscess: diagnosis and management.

Koon-Kwan Ng1, Tze-Yu Lee, Yung-Liang Wan

  • 1Department of Diagnostic Radiology, Chang Gung Memorial Hospital at Linkou & Kaohsiang, Taiwan.

Hepato-Gastroenterology
|May 9, 2002
PubMed
Summary

Combining computed tomography and sonography aids in diagnosing splenic abscesses. This imaging approach, alongside clinical signs, improves early detection and guides effective treatment, reducing high mortality rates.

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Area of Science:

  • Radiology and Imaging
  • Infectious Diseases
  • Abdominal Surgery

Background:

  • Splenic abscess is a rare but potentially fatal condition.
  • Delayed diagnosis and treatment significantly increase mortality.
  • Accurate diagnostic tools are crucial for timely intervention.

Purpose of the Study:

  • To assess the combined utility of computed tomography (CT) and sonography for diagnosing splenic abscess.
  • To determine the role of these imaging modalities in guiding management decisions.
  • To correlate imaging findings with patient outcomes.

Main Methods:

  • Retrospective review of 30 patients with pyogenic splenic abscesses (January 1986 - June 1999).
  • All patients underwent CT; 26 had abdominal sonography.

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  • Imaging findings were analyzed alongside clinical presentations, predisposing factors, and outcomes.

    • Main Results:

    • The clinical triad (fever, left upper quadrant pain, leukocytosis) was common (92%, 77%, 66%).
    • CT and sonography revealed specific findings like abnormal gas (6/30), progressive enlargement (6/30), and fluid collections (8/30).
    • Combining clinical data with imaging increased the diagnostic rate to 86.7%.

    Conclusions:

    • CT and sonography, when integrated with clinical features, enable early diagnosis of splenic abscess.
    • Percutaneous drainage is effective for single abscesses; splenectomy is suitable for multiple abscesses.
    • Imaging appearance predicts treatment outcomes, highlighting the inadequacy of medical treatment alone.