Splenic Abscesses With Different Modalities of Management: A Case Series

Splenic abscesses are rare but potentially fatal infections, particularly in individuals with diabetes mellitus. Management strategies vary based on the abscess size, complexity, and response to the initial treatment. We report five patients with diabetes and splenic abscesses who were managed at a tertiary care centre. All patients presented with left upper quadrant pain, fever, and leukocytosis. The diagnosis was confirmed via ultrasonography and contrast-enhanced computed tomography. One patient was managed conservatively with antibiotic therapy. Two patients underwent successful image-guided pigtail drainage, while one required splenectomy due to persistent infection. The remaining two patients underwent direct open splenectomy due to large loculated abscesses or lack of clinical improvement. The cultured isolates included E. coli, Staphylococcus epidermidis, and Acinetobacter species, and all patients recovered well. A tailored, stepwise approach to splenic abscesses, beginning with imaging, followed by medical or minimally invasive management, and escalating to surgery when necessary, yields favourable outcomes.