Ng Chee Yung, Leong E Chuan, Chng Hong Chee
Department of General Surgery, Tan Tock Seng Hospital, Singapore.
Ann Acad Med Singap. 2008 Sep;37(9):749-52.
Splenic abscess is an uncommon clinical problem. Traditionally, the "gold standard" treatment has been splenectomy. However, there is increasing use of non-operative treatments worldwide.
A 10-year (1996-2005) retrospective review of case records from a single centre (an 800-bed general hospital) was performed. Information regarding demographics, clinical presentation, aetiological agents and management was gathered and analysed.
There were 21 cases from 1996 to 2005. Nineteen (90%) had multiple abscesses. Disseminated melioidosis was the most common aetiological agent (15 cases, 71%). Only 3 patients underwent splenectomy. The remainder were treated conservatively with antibiotics. Almost all the patients (19, 90%) also suffered from diabetes mellitus.
The most common aetiological agent encountered was Burkholderia pseudomallei. Diabetes mellitus may be an important co-factor in the pathogenesis of splenic abscesses. The majority of our patients were managed conservatively and splenectomy was only occasionally required.
脾脓肿是一种不常见的临床问题。传统上，“金标准”治疗方法是脾切除术。然而，全球范围内非手术治疗的应用越来越多。
对一家单一中心（一家拥有800张床位的综合医院）10年（1996 - 2005年）的病例记录进行回顾性研究。收集并分析了有关人口统计学、临床表现、病原体和治疗方法的信息。
1996年至2005年期间有21例病例。19例（90%）有多个脓肿。播散性类鼻疽是最常见的病原体（15例，71%）。仅3例患者接受了脾切除术。其余患者采用抗生素保守治疗。几乎所有患者（19例，90%）也患有糖尿病。
最常见的病原体是伯克霍尔德菌属假鼻疽杆菌。糖尿病可能是脾脓肿发病机制中的一个重要协同因素。我们的大多数患者采用保守治疗，仅偶尔需要进行脾切除术。
