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Published on: December 20, 2024
Abscesses of the spleen: report of three cases
Constantin Fotiadis1, Giagkos Lavranos, Pavlos Patapis
13rd Department of Surgery, Attikon University Hospital, Piraeus 18538, Greece.
Abstract:
Abscess of the spleen is a rare discovery, with about 600 cases in the international literature so far. Although it may have various causes, it is most usually associated with trauma and infections of the spleen. The latter are more common in the presence of a different primary site of infection, especially endocarditis or in cases of ischemic infarcts that are secondarily infected. Moreover, immunosuppression is a major risk factor. Clinical examination usually reveals a combination of fever, left-upper-quadrant abdominal pain and vomiting. Laboratory findings are not constant. Imaging is a necessary tool for establishing the diagnosis, with a choice between ultrasound and computed tomography. Treatment includes conservative measures, and surgical intervention. In children and in cases of solitary abscesses with a thick wall, percutaneous catheter drainage may be attempted. Otherwise, splenectomy is the preferred approach in most centers. Here, we present three cases of splenic abscess. In all three, splenectomy was performed, followed by rapid clinical improvement. These cases emphasize that current understanding of spleen abscess etiology is still limited, and a study for additional risk factors may be necessary.
Insights
Splenic abscess is a rare condition often linked to spleen trauma or infection. Surgical removal (splenectomy) offers rapid improvement, but more research is needed on risk factors.
Area of Science:
- Infectious Diseases
- Surgical Pathology
- Abdominal Imaging
Background:
- Splenic abscess is a rare clinical entity, with limited cases reported globally.
- Common causes include splenic trauma, infection (especially endocarditis), and secondary infection of ischemic infarcts.
- Immunosuppression represents a significant risk factor for developing splenic abscess.
Observation:
- Clinical presentation typically involves fever, left-upper-quadrant abdominal pain, and vomiting.
- Laboratory findings are often inconsistent, necessitating advanced diagnostic methods.
- Imaging modalities like ultrasound and computed tomography are crucial for diagnosis.
Findings:
- This study presents three cases of splenic abscess, all treated successfully with splenectomy.
- All patients experienced rapid clinical improvement post-splenectomy.
- The cases highlight the need for further investigation into the etiology and risk factors of splenic abscess.
Implications:
- Current understanding of splenic abscess etiology remains incomplete.
- Further research into identifying additional risk factors is warranted.
- Splenectomy is a highly effective treatment for splenic abscess, leading to prompt recovery.
