Rattan Kamal N, Kadian Yogender S, Saroha Vikas, Jindal Nipun
Department of Paediatric Surgery, Pt. B. D. Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India.
Afr J Paediatr Surg. 2009 Jul-Dec;6(2):106-9. doi: 10.4103/0189-6725.54774.
Splenic abscess is uncommon in paediatric age group. It usually occurs in conditions of disseminated infective focus. Conventional treatment of abscess is incision and drainage, although splenectomy or splenic conservation is alternative. In this report, we are presenting case summaries of three patients suffering from splenic abscess. A retrospective review of three children was managed for splenic abscess in our institution.All three patients presented with pyrexia, weight loss, and recurrent abdominal pain for more than six weeks. Human immunodeficiency virus (HIV) antibody detection test (ELISA) was nonreactive in all of them. The first patient was managed by splenectomy because of multiple splenic abscesses involving the entire spleen; the second one had exploratory laparotomy and drainage of splenic abscess with preservation of the spleen; and the third patient had successful ultrasonic guided aspiration of abscess. The follow-up ultrasonography done after three and six months in two patients, with splenic conservation, did not reveal any recurrence of abscess. In children with splenic abscess, ultrasound guided aspiration of abscess should be the first line of treatment, when this fails either because of multiple abscesses or dense adhesions around the spleen then splenectomy or open drainage may become necessary.
脾脓肿在儿童年龄组中并不常见。它通常发生在存在播散性感染病灶的情况下。脓肿的传统治疗方法是切开引流，不过脾切除术或保留脾脏也是可供选择的方法。在本报告中，我们呈现了三名脾脓肿患儿的病例摘要。对在我们机构接受治疗的三名儿童进行了回顾性研究。所有三名患者均表现出发热、体重减轻以及持续超过六周的反复腹痛。他们所有人的人类免疫缺陷病毒（HIV）抗体检测试验（ELISA）均为阴性。第一名患者因多个脾脓肿累及整个脾脏而接受了脾切除术；第二名患者接受了剖腹探查术并对脾脓肿进行了引流，同时保留了脾脏；第三名患者成功进行了超声引导下脓肿抽吸术。两名保留脾脏的患者在术后三个月和六个月进行的超声复查未发现脓肿复发。对于患有脾脓肿的儿童，超声引导下脓肿抽吸术应作为首选治疗方法，若因脓肿数量过多或脾脏周围粘连致密而导致该方法失败，则可能需要进行脾切除术或开放引流。
