Fall B, Dansokho A, Tetimian D, Ka M, Toure H P
Clinique Chirurgicale, C.H.U. de Dakar, Hôpital A. Le Dantec, Sénégal.
J Chir (Paris). 1991 May;128(5):256-9.
Spleen abscesses are infrequent, and are encountered in 0.4 to 0.7%-of the autopsy series. They are diagnosed late and their prognosis is poor. The authors report about 5 cases of spleen abscesses observed at Dakar's University Surgical Clinic over a period of 30 years. The patients were young adults, including one case of sickle-cell anemia. In spite of numerous clinical signs in all cases, the abscess was diagnosed late. In three patients, ultrasound allowed establishing the diagnosis and initiating percutaneous treatment, with no success in two cases. The procedure had consisted in total splenectomy in all cases. One patient died 2 months after surgery, after the evacuation of a hematoma in the splenic compartment. The other 4 patients, seen 7, 4, 3 months and 15 years after total splenectomy, no longer presented with any symptom. The authors emphasize the rarity of spleen abscesses; the fact that the diagnosis is often established late, in spite of the progress made in non-invasive medical imaging, including CT and ultrasound; the physiopathology, etiology and treatment of the disease, the latter still being surgical.
脾脓肿较为罕见，在尸检系列中占0.4%至0.7%。其诊断往往较晚，预后较差。作者报告了在达喀尔大学外科诊所30年间观察到的5例脾脓肿病例。患者均为年轻成年人，其中1例为镰状细胞贫血。尽管所有病例都有众多临床症状，但脓肿诊断仍较晚。3例患者经超声检查得以确诊并开始经皮治疗，其中2例治疗失败。所有病例均实施了全脾切除术。1例患者在术后2个月因脾区血肿清除后死亡。另外4例患者在全脾切除术后7个月、4个月、3个月和15年接受观察，均未再出现任何症状。作者强调了脾脓肿的罕见性；尽管包括CT和超声在内的非侵入性医学影像技术取得了进展，但诊断仍常较晚确立这一事实；该病的生理病理学、病因及治疗方法，目前治疗仍以外科手术为主。
