ABSTRACT
OBJETIVO: Relatar as características demográficas, clínicas, diagnóstica e terapêutica de pacientes com abscesso esplênico (AE) causado por Salmonella. MÉTODO: Análise retrospectiva de dados de pacientes atendidos no Serviço de Cirurgia Geral e Aparelho Digestivo do Hospital Universitário Gaffrée-Guinle no período de janeiro de 2001 a dezembro de 2005, a estes se incluiu um caso tratado em outro hospital em época anterior. RESULTADOS: Dentre 4823 pacientes recentemente atendidos, dois apresentaram AE causado por Salmonella enteritidis, enquanto o caso mais antigo o agente responsável foi a Salmonella typhi. Todos eram homens, com idade média de 45 anos. Em nenhum deles foi identificada condição predisponente à formação do abscesso; os exames de imagem foram capazes de diagnosticar o AE. Todos foram tratados por esplenectomia e antibioticoterapia e evoluíram para cura. CONCLUSÕES: A Salmonella, apesar de infrequente, pode ser o agente causal do AE. Caracteristicamente os abscessos eram grandes e apresentavam material necrótico em seu interior. Nesta condição, a esplenectomia associada a antibioticoterapia mostrou-se eficaz no tratamento.
BACKGROUND: Splenic abscess is a uncommon disease and remains a diagnostic challenge. Outcome is fatal when the condition is not promptly recognized and treated. The aim of this study was to analyze the demographic, clinical, diagnostic methods and management characteristic of patients with salmonelal splenic abscess. METHODS: Retrospective study at General and Digestive Surgery Service - Hospital Universitário Gaffrée-Guinle of the Universidade Federal do Estado do Rio de Janeiro - UNIRIO from January 2001 to December 2005 resulting in a total number of 4823 patients has been performed. An additional case treated by one author was added. RESULTS: During the studied period two cases of splenic abscess due to Salmonella enteritidis was treated; a third older case was due to Salmonella typhi. All patients were man; the mean age was 45 years, all were immunocompetent and had large solitary lesion. All patients underwent splenectomy and antibiotic therapy; the outcome was favorable for all patients. CONCLUSION: Nowadays still is possible that splenic abscess is due to Salmonella species etiology; typically, all patients are immunocompetents adult males and large solitary lesions within necrotic material. In this condition, splenectomy and intravenous antibiotic administration appear to constitute the most convenient therapy.