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Robot-Assisted Laparoscopic Splenectomy In Children: A Case Report with Literature Review
Published on: March 27, 2026
Management of splenic abscess in children by percutaneous drainage
Roy Choudhury S1, Chadha Rajiv, Sonker Pitamber
1Department of Pediatric Surgery, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi 110001, India. roychouin@yahoo.co.in
Insights
Pediatric splenic abscesses can be effectively treated with needle aspiration and antibiotics, preserving the spleen. This conservative approach avoids the need for splenectomy in children.
Area of Science:
- Pediatric surgery
- Infectious diseases
- Radiology
Background:
- Splenic abscesses are uncommon in children.
- Historically, splenectomy was the primary treatment.
- Conservative management is gaining traction.
Observation:
- Four pediatric patients (7-11 years) presented with fever, anorexia, and left hypochondrial pain.
- Imaging revealed splenic abscesses (solitary or multiple).
- Cultures identified Escherichia coli and Salmonella paratyphi A in some cases.
Findings:
- All patients responded well to conservative treatment.
- Ultrasound-guided needle aspiration and antibiotics were successful.
- No patient required splenectomy.
Implications:
- Needle aspiration and antibiotics offer a viable alternative to splenectomy for pediatric splenic abscess.
- Spleen preservation is achievable through minimally invasive techniques.
- This approach can improve outcomes and reduce morbidity in pediatric patients.
Background/Purpose:
Isolated splenic abscesses are rare in pediatric patients. The recommended treatment in the literature has been in favor of splenectomy, although conservative treatment with splenic preservation is being increasingly reported. We report successful management of 4 pediatric patients with splenic abscess by needle aspirations and antibiotics.
Materials And Methods:
Four children (aged 7-11 years; male-female, 3:1) were admitted in our institution with history of high-grade fever with chills, anorexia, left hypochondrial pain, and splenomegaly. One child was a known case of thalassemia, and one had a history of typhoid fever. The others did not have any predisposing condition. Ultrasonography (USG) and computed tomographic scan of the abdomen showed a solitary abscess in the spleen in 2 patients and multiple abscesses in the other 2. Ultrasonography-guided needle aspiration in 3 cases revealed purulent fluid, which, on culture, grew Escherichia coli in 1 case, Salmonella paratyphi A in 1 case, but sterile in 1 case. Blood culture was sterile in all the cases, but Widal's test was positive in 2 patients. Treatment protocol included USG-guided needle aspiration of pus along with intravenous ceftriaxone, metronidazole, and amikacin for 3 to 12 weeks.
Results:
All 4 patients showed a good response to conservative treatment. Serial USG showed gradual resolution of abscess, and none was subjected to splenectomy.
Conclusion:
Isolated splenic abscess in children can be successfully treated with needle aspirations and intravenous antibiotics, thereby avoiding splenectomy.
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