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儿科人群中的脾脓肿:一种罕见病症的文献综述

Splenic Abscesses in the Pediatric Population: A Literature Review of an Uncommon Entity.

作者信息

Arora Nikhil, Dhawan Shefali

机构信息

Pediatrics, Government Medical College, Patiala, Patiala, IND.

Radiodiagnosis, Government Medical College, Patiala, Patiala, IND.

出版信息

Cureus. 2024 Jul 28;16(7):e65607. doi: 10.7759/cureus.65607. eCollection 2024 Jul.

DOI:10.7759/cureus.65607
PMID:39205713
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11350243/
Abstract

Splenic abscess in the pediatric population is a rare but serious condition. Its incidence is reported to be between 0.05% and 0.7%. Splenic abscess is an infectious suppurative process with a discernible macroscopic filling defect in the subcapsular space or spleen parenchyma. Causes include bacterial infection through the hematogenous route or from locoregional spread such as the gastrointestinal tract, septic emboli, trauma, sickle cell anemia, and malarial infestation. Diagnosis is often delayed due to non-specific signs and symptoms. Symptoms include fever, abdominal pain, and palpable left upper abdominal swelling. Ultrasound and cross-sectional imaging such as CT scans are useful for the diagnosis of splenic abscess but contrast-enhanced CT scans are considered the gold standard because of their high sensitivity and specificity. Treatment options range from antimicrobial therapy, percutaneous drainage, and aspiration to surgical interventions such as splenectomy. As it has a high mortality rate, prompt diagnosis and appropriate treatment are essential for optimal outcomes.

摘要

小儿脾脓肿是一种罕见但严重的病症。据报道,其发病率在0.05%至0.7%之间。脾脓肿是一种感染性化脓性病变,在脾包膜下间隙或脾实质内有明显的宏观充盈缺损。病因包括通过血行途径的细菌感染或来自局部扩散,如胃肠道、脓毒性栓子、创伤、镰状细胞贫血和疟疾感染。由于症状和体征不具特异性,诊断往往会延迟。症状包括发热、腹痛和可触及的左上腹肿胀。超声和CT扫描等横断面成像对脾脓肿的诊断有用,但增强CT扫描因其高敏感性和特异性而被视为金标准。治疗选择包括抗菌治疗、经皮引流、穿刺抽吸以及脾切除术等手术干预。由于其死亡率高,及时诊断和适当治疗对于取得最佳治疗效果至关重要。

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Cureus. 2024 Feb 25;16(2):e54866. doi: 10.7759/cureus.54866. eCollection 2024 Feb.
2
Splenic Abscess in an Adolescent due to Conservatively Treated with Ultrasound-Guided Fine-Needle Aspiration.一名青少年因超声引导下细针穿刺保守治疗导致脾脓肿。
Case Rep Pediatr. 2023 Mar 13;2023:8802760. doi: 10.1155/2023/8802760. eCollection 2023.
3
Brucellosis with splenic abscess in a child initially suspected to have covid-19.儿童布鲁氏菌病伴脾脓肿,最初疑似感染新冠病毒。
Trop Doct. 2022 Jan;52(1):151-152. doi: 10.1177/00494755211062022. Epub 2021 Nov 29.
4
Utilization of Point-of-Care Ultrasound to Detect Splenic Microabscesses in Pediatric Melioidosis.床旁超声在小儿类鼻疽脾微脓肿检测中的应用
Cureus. 2021 Mar 8;13(3):e13760. doi: 10.7759/cureus.13760.
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Large Splenic Abscess Caused by Non-Typhoidal in a Healthy Child Treated with Percutaneous Drainage.健康儿童非伤寒性大肠埃希菌所致巨大脾脓肿经皮引流治疗
Children (Basel). 2020 Aug 3;7(8):88. doi: 10.3390/children7080088.
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Cureus. 2019 Jul 23;11(7):e5210. doi: 10.7759/cureus.5210.
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Can J Infect Dis Med Microbiol. 2018 Jan 31;2018:8610657. doi: 10.1155/2018/8610657. eCollection 2018.
8
Case report of successful partial splenectomy for a splenic abscess in a paediatric patient.小儿脾脓肿行部分脾切除术成功的病例报告。
Int J Surg Case Rep. 2017;38:176-179. doi: 10.1016/j.ijscr.2017.07.050. Epub 2017 Jul 25.
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Splenic Abscess in Immunocompetent Patients Managed Primarily without Splenectomy: A Series of 7 Cases.免疫功能正常患者主要非脾切除治疗脾脓肿:7例病例系列
Perm J. 2017;21:16-139. doi: 10.7812/TPP/16-139.
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