Abscesos esplénicos: Comunicación de siete casos y revisión de la literatura / Splenic abscesses: Report of seven cases

ABSTRACT

Background: Splenic abscesses are uncommon, appear in subjects with predisposing factors such as systemic infections and have high mortality rates. Aim: To report seven patients with splenic abscesses. Material and Methods: Retrospective review of medical records of patients with a splenic abscess treated between 1987 and 2005. Results: The records of four women and three males aged 20 to 74 years, were reviewed. The most common presenting symptoms were fever and abdominal pain and all had predisposing factors. Six patients had a leukocyte count of 19,500 x mm³. Mean erythrocyte sedimentation rate and C reactive protein values were 75 mm/h and 13.5 mg/dl. Diagnosis was made with ultrasound in two patients and CT scan in five. Six patients had an unique abscess and one patient had multiple lesions. A splenectomy was done in three patients as the first choice treatment and in one, due to medical treatment failure. In two patients, a CT guided percutaneous drainage was performed and one patient was subjected to medical treatment only. Abscess cultures were positive in 50 percent of patients subjected to percutaneous drainage and in 50 percent of splenectomized patients. No patient died and no complications were observed in the early or ¡ate postoperative period. Conclusion: Splenic abscesses are associated to predisposing conditions. The first choice is surgical treatment, but percutaneous drainage is also a therapeutic option.