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The changing spectrum of splenic abscess

P L Caslowitz1, J D Labs, E K Fishman

  • 1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland.

Clinical Imaging
|September 1, 1989
PubMed

Insights

Diagnosing splenic abscesses has improved due to advanced imaging, leading to faster treatment and significantly lower mortality rates compared to previous decades. This is particularly noted in cases of multiple abscesses.

Area of Science:

  • Medicine
  • Radiology
  • Pathology

Background:

  • Splenic abscess is a rare condition.
  • Increased incidence linked to immunosuppressed patients and advanced imaging.
  • Retrospective review of 13 cases from 1978-1986.

Purpose of the Study:

  • To review cases of splenic abscess.
  • To evaluate diagnostic methods and outcomes.
  • To assess the impact of modern diagnostics on mortality.

Main Methods:

  • Retrospective analysis of medical and pathological records.
  • Review of 13 splenic abscess cases.
  • Evaluation of diagnostic imaging, including computed tomography (CT).

Main Results:

  • Five solitary abscesses (SA) and eight multiple abscesses (MA) were identified.
  • Seventy-five percent of MA patients were immunosuppressed; none died.
  • Overall mortality decreased to 10% (1/13), significantly lower than historical rates (40-70%).
  • Diagnosis time improved (3.8 days for SA, 1.8 days for MA).
  • CT was highly effective in diagnosing splenic abscess.

Conclusions:

  • Modern diagnostic techniques, especially CT, enable earlier and more accurate diagnosis of splenic abscess.
  • Prompt diagnosis and treatment have drastically reduced mortality rates.
  • Immunosuppressed patients with multiple splenic abscesses have a better prognosis than previously thought.

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