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Conservative management of splenic abscesses in children
E T Fernandes1, P B Tavares, C B Garcette
1Division of Pediatric Surgery, Hospital de Clínicas de Universidade Estadual do Rio de Janeiro, Brazil.
Insights
Conservative management with antibiotics can successfully treat splenic abscesses in children, avoiding the need for splenectomy. This approach preserves spleen function, which is crucial for pediatric immune health.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
Background:
- Splenic abscesses are uncommon in pediatric patients.
- Traditional treatment involves splenectomy and antibiotics.
Observation:
- Two pediatric cases of splenic abscesses (one single, one multiple) were successfully managed conservatively.
- Treatment included intravenous antibiotics followed by oral chemotherapy.
Findings:
- Abdominal ultrasonography confirmed lesion regression in both patients.
- Conservative antibiotic therapy led to positive outcomes.
Implications:
- Spleen preservation is vital in children.
- Antibiotic therapy should be the initial treatment for pediatric splenic abscesses.
- Surgery is reserved for refractory cases or clinical deterioration.
Abstract:
Splenic abscesses are rare in children. The recommended treatment for this entity has been a combination of total splenectomy and appropriate antibiotic therapy. We report on the successful conservative management of two children with splenic abscesses. The patients were a girl with a single splenic abscess and a boy with multiple splenic lesions. Both were managed by parenteral antibiotic therapy followed by oral chemotherapy. Regression of the lesions was documented by repeated abdominal ultrasonographic examinations. Considering the good outcome of these patients and the importance of splenic preservation in children, we propose that management of children with single or multiple splenic abscesses should begin by a course of vigorous antibiotic therapy, reserving more aggressive surgical procedures for those who do not respond to conservative treatment or have clinical deterioration.