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Splenic abscess and sickle cell disease
A H Al-Salem1, S Qaisaruddin, A Al Jam'a
1Department of Surgery, Qalif Central Hospital, Saudi Arabia.
American Journal of Hematology
|June 13, 1998
Summary
Splenic abscess in sickle cell disease (SCD) patients requires prompt diagnosis. Splenectomy is the recommended treatment, offering a mortality-free outcome for these patients.
Area of Science:
- Medicine
- Hematology
- Infectious Diseases
Background:
- Sickle cell disease (SCD) patients are at increased risk for splenic complications, including abscess formation.
- Splenic abscesses in SCD often present with non-specific symptoms like fever and abdominal pain, complicating early diagnosis.
Purpose of the Study:
- To report the experience with 10 cases of splenic abscess in patients with sickle cell disease.
- To evaluate diagnostic modalities and determine the optimal management strategy for splenic abscess in SCD.
Main Methods:
- Retrospective review of 10 patients with SCD and splenic abscess.
- Evaluation of diagnostic accuracy of ultrasound and CT-scan.
- Analysis of treatment outcomes with antibiotics, splenectomy, and aspiration.
Main Results:
- CT-scan was found to be more accurate than ultrasound for diagnosing splenic abscess.
- All patients managed with antibiotics and splenectomy had no mortality.
- Salmonella was the most common causative organism identified.
Conclusions:
- Routine use of imaging (ultrasound/CT-scan) is recommended for SCD patients with fever, abdominal pain, and tender splenomegaly.
- Splenectomy is the preferred treatment for splenic abscess in SCD patients due to non-functioning spleens.
- CT-guided aspiration may be a temporary option for high-risk patients with unilocular abscesses.