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Absesos del bazo con diferentes modalidades de tratamiento: una serie de casos
Chakravarthi Vainatheya Peramur Hemambjam Nallan1, Arulappan T1, Sivaraja Pk1
1General Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Cureus
|September 5, 2025
Resumen
Los abscesos del bazo en pacientes diabéticos requieren un tratamiento adaptado. Un enfoque gradual, desde la imagen hasta la intervención quirúrgica o mínimamente invasiva, conduce a una recuperación exitosa del paciente.
Área de la Ciencia:
- Enfermedades infecciosas
- Cirugía abdominal
- Diabetología
Sus antecedentes:
- Los abscesos del bazo son infrecuentes pero pueden poner en peligro la vida.
- La diabetes mellitus es un factor de riesgo significativo para el desarrollo de abscesos esplénicos.
- Las estrategias de manejo óptimas para los abscesos esplénicos no están definidas universalmente.
Objetivo del estudio:
- Informar sobre el tratamiento de cinco pacientes diabéticos con abscesos esplénicos.
- Evaluar la eficacia de un enfoque de gestión por etapas.
- Para resaltar los resultados basados en la modalidad de tratamiento.
Principales métodos:
- Serie de casos retrospectivos de cinco pacientes con diabetes y absceso del bazo.
- El diagnóstico fue confirmado por ultrasonografía y tomografía computarizada con contraste.
- El tratamiento incluyó terapia conservadora con antibióticos, drenaje guiado por imágenes y esplenectomía (abierta o mínimamente invasiva).
Principales resultados:
- Todos los pacientes presentaron síntomas clásicos: dolor en el cuadrante superior izquierdo, fiebre y leucocitosis.
- Se emplearon diversos enfoques de manejo: conservador (1), drenaje de cola de cerdo (2) y esplenectomía (2).
- Se logró una recuperación exitosa en todos los pacientes, con patógenos identificados incluyendo E. coli, Staphylococcus epidermidis y especies de Acinetobacter.
Conclusiones:
- Una estrategia de tratamiento gradual y adaptada para los abscesos esplénicos es eficaz.
- El diagnóstico temprano a través de imágenes es crucial.
- Las intervenciones quirúrgicas o mínimamente invasivas deben considerarse en función de la respuesta clínica y las características del absceso.
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