[Splenic abscesses. Their percutaneous treatment and the role of the interventional radiologist]

Percutaneous abscess drainage is not as common in the spleen as in other anatomical sites, probably because of an uncontrollable fear of bleeding. Five cases of intrasplenic abscess drainage are presented. A double-way 12/14-F vanSonnenberg catheter was percutaneously inserted under CT guidance in four patients and under US guidance in one patient. Orthogonal scout CT views were useful to check the correct positioning of the drainage. In three patients the maneuver was successful, with no recurrence at follow-up at 12, 16 and 24 months, respectively. In one patient with a splenic abscess due to iatrogenic ischemic necrosis, the drainage allowed delayed surgery after relief of symptoms. Another patient died of sepsis five days after multiple well-functioning drainages. No early or late complications occurred. Bleeding was never observed in our series and there are no recent literature reports on this complication. Whenever it occurs, bleeding can be treated with selective embolization. In our experience, the percutaneous drainage of splenic abscesses, performed by the radiologist, should be considered the treatment of choice in these cases.