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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
PubMed
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.

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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.

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