Lombardi A, Coppola M, Pennica A, Maglio R, Moscaroli A, Lo Russo M, Provenza G
Università of Rome La Sapienza, 2nd School of Medicine and Surgery, S. Andrea Hospital, Department of Surgery, Rome.
G Chir. 2008 Aug-Sep;29(8-9):359-61.
Splenic abscess is a rare condition. Haematogenous seeding to the spleen from an infection at a distant site, most often endocarditis, is been the most common predisposing condition but an increase has been observed in immuno-compromised patients too. Fever, leukocytosis and left upper quadrant pain are suggestive, but the signs and symptoms of splenic abscesses are often non-specific. Rare is the onset with diarrhoea as in our case. Ultrasound and computed tomography are reliable diagnostic tools. Splenectomy and antibiotics are the treatments of choice. We describe a case of splenic abscess with gas level and peritonitis from dissemination of Streptococcus anginosus (of Streptococcus millerii group) from duodenal ulcer contaminated. It was diagnosed with CT, ultrasound, and abdomen X-ray with contrast then treated with splenectomy and peritoneal lavage.
脾脓肿是一种罕见病症。远处部位感染(最常见的是心内膜炎)经血行播散至脾脏是最常见的易感因素,但免疫功能低下患者中也观察到发病率有所增加。发热、白细胞增多和左上腹疼痛有一定提示作用,但脾脓肿的体征和症状往往不具有特异性。像我们这个病例以腹泻起病的情况较为罕见。超声和计算机断层扫描是可靠的诊断工具。脾切除术和抗生素是首选治疗方法。我们描述了一例因十二指肠溃疡感染的米勒链球菌群(咽峡炎链球菌)播散导致的脾脓肿伴气腹和腹膜炎病例。通过CT、超声和腹部造影X线确诊后,行脾切除术和腹腔灌洗治疗。