Rational approach to therapy in splenic abscess

Intrasplenic abscess is an uncommon but potentially lethal condition. Seven cases of splenic abscess were seen between 1985 and 1988. There are no specific clinical findings; symptoms and signs of fever, abdominal pain and tenderness were present in all seven cases but were only helpful in diagnosing splenic abscess in three cases. Computed tomographic scanning probably at present offers the most direct way of evaluating the spleen and making an early diagnosis. Splenectomy was done in three cases and antibiotics were used in four cases with equally successful results. Contrary to the prevalent opinion, we believe that medical management is an important addition to the surgeon's armamentarium and offers a viable alternative in selected cases of splenic abscess. A successful outcome is dependent on a high degree of clinical alertness, an aggressive diagnostic approach and prompt effective treatment.