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不同治疗方式的脾脓肿:病例系列

Splenic Abscesses With Different Modalities of Management: A Case Series.

作者信息

Peramur Hemambjam Nallan Chakravarthi Vainatheya, T Arulappan, Pk Sivaraja

机构信息

General Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.

出版信息

Cureus. 2025 Aug 4;17(8):e89325. doi: 10.7759/cureus.89325. eCollection 2025 Aug.

Abstract

Splenic abscesses are rare but potentially fatal infections, particularly in individuals with diabetes mellitus. Management strategies vary based on the abscess size, complexity, and response to the initial treatment. We report five patients with diabetes and splenic abscesses who were managed at a tertiary care centre. All patients presented with left upper quadrant pain, fever, and leukocytosis. The diagnosis was confirmed via ultrasonography and contrast-enhanced computed tomography. One patient was managed conservatively with antibiotic therapy. Two patients underwent successful image-guided pigtail drainage, while one required splenectomy due to persistent infection. The remaining two patients underwent direct open splenectomy due to large loculated abscesses or lack of clinical improvement. The cultured isolates included and species, and all patients recovered well. A tailored, stepwise approach to splenic abscesses, beginning with imaging, followed by medical or minimally invasive management, and escalating to surgery when necessary, yields favourable outcomes.

摘要

脾脓肿虽罕见但可能致命,尤其在糖尿病患者中。治疗策略因脓肿大小、复杂性及对初始治疗的反应而异。我们报告了在一家三级医疗中心接受治疗的5例糖尿病合并脾脓肿患者。所有患者均表现为左上腹疼痛、发热和白细胞增多。通过超声检查和增强计算机断层扫描确诊。1例患者采用抗生素治疗保守处理。2例患者成功接受了影像引导下的猪尾导管引流,1例因持续感染需要行脾切除术。其余2例患者因脓肿分隔较大或临床症状无改善而接受了直接开放性脾切除术。培养分离出的菌株包括[具体菌株]和[具体菌株],所有患者恢复良好。对于脾脓肿,采用从影像学检查开始,接着进行药物或微创治疗,必要时升级为手术的定制化、逐步治疗方法,可取得良好效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd85/12406614/654825c1dc02/cureus-0017-00000089325-i01.jpg

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