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Splenic abscess: outcome and prognostic factors.
Abdul Rehman Alvi1, Shazia Kulsoom, Ghina Shamsi
1Department of Surgery, The Aga Khan University Hospital, Karachi. rehman.alvi@aku.edu
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|November 27, 2008
Summary
Splenic abscess is a rare condition, often presenting with fever and abdominal pain. Non-operative treatments are frequently successful, but splenectomy may be necessary for large abscesses or treatment failures.
Area of Science:
- General Surgery
- Infectious Diseases
- Radiology
Background:
- Splenic abscess is an uncommon but serious surgical condition.
- Timely diagnosis and appropriate management are crucial for patient outcomes.
Purpose of the Study:
- To investigate the clinical presentation, treatment outcomes, and prognostic factors of splenic abscess.
- To evaluate the effectiveness of different treatment modalities for splenic abscess.
Main Methods:
- A retrospective case-series study of 27 patients diagnosed with splenic abscess between 1988 and 2007.
- Data collected included demographics, clinical findings, radiological results, treatment, and outcomes.
- Treatment modalities included intravenous antibiotics, percutaneous drainage, and splenectomy.
Main Results:
- Common symptoms included fever (92.6%) and abdominal pain (55.6%).
- Staphylococcus species and gram-negative rods were the most common pathogens.
- Survival rates were 84% for antibiotics, 87.5% for percutaneous drainage, and 83% for splenectomy, with no significant difference between groups.
- Abscess size and hospital stay differed significantly between treatment groups.
Conclusions:
- Splenic abscess requires a high index of suspicion and liberal use of radiological imaging for diagnosis.
- Non-operative management is effective for most patients.
- Splenectomy is a safe option for large abscesses (>10 cm) or treatment failures.
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