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Splenic abscesses from 1987 to 1995

L L Ooi1, S S Leong

  • 1Department of Surgery, Singapore General Hospital, Singapore.

American Journal of Surgery
|July 1, 1997
PubMed
Summary

Splenic abscesses are increasingly recognized, especially in immunosuppressed patients. While percutaneous drainage can help some, splenectomy with antibiotics remains the definitive treatment for this intraabdominal sepsis.

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Area of Science:

  • Infectious Diseases
  • Surgical Pathology
  • Abdominal Imaging

Background:

  • Splenic abscesses, though uncommon, are increasingly identified as a source of intraabdominal sepsis.
  • The rise in immunosuppressed states (e.g., chemotherapy, transplantation, AIDS) has altered the presentation of splenic abscesses.
  • A wide range of organisms can cause splenic abscesses.

Purpose of the Study:

  • To analyze trends and characteristics of splenic abscesses.
  • To compare recent cases with historical data.
  • To evaluate diagnostic and therapeutic outcomes.

Main Methods:

  • Systematic review of 287 English-language cases from 1987-1995.
  • Comparison with pre-1987 literature reviews.
  • Analysis of causative organisms, patient risk factors, diagnostic modalities, and treatment outcomes.

Main Results:

  • Common organisms include Staphylococcus, Salmonella, and Escherichia coli.
  • Immunosuppression was present in 33.5% of cases, notably in intravenous drug users and AIDS patients.
  • Diagnostic imaging sensitivity: CT (92.2%), Ultrasound (87.2%). Nonoperative management success rate <65%; salvage splenectomy did not increase mortality.

Conclusions:

  • Splenic abscesses are increasingly associated with immunosuppression.
  • Percutaneous drainage is a viable option for select cases.
  • Splenectomy combined with antibiotics is the established definitive treatment.

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