Rakovec S, Zakelj V, Porenta M
Acta Chir Iugosl. 1979;26(2):27-32.
Abscess of the spleen is an uncommon entity that seems even less common as it still represents a diagnostic problem. The most common cause of splenic abscess is metastatic hematogenous seeding of the diseased spleen especially of the infarcted areas or traumatic hematomas. It can result also from the direct spread of infection from surrounding structures. Many patients with splenic abscess have a rapidly progressive generalized sepsis and even the combination of well-timed surgery and antibiotic therapy is not always curative. Local symptoms may be mild and overlooked and there may be only general symptoms of suppuration present. X-rays investigations often yield valuable information about the location of the abscess. By far the most promising technique is splenic scanning with the use of radioisotopes. Our case of splenic abscess following appendicitis has been described. The course and the diagnosis has been established using liver-spleen scanning. The patient was treated with Obracin and Dalacin and the diseased spleen has been removed. After drainage of the left subphrenic abscess the recovery was uneventful.
脾脓肿是一种罕见的病症，由于它仍然是一个诊断难题，所以似乎更为少见。脾脓肿最常见的病因是患病脾脏尤其是梗死区域或创伤性血肿的血行性转移播散。它也可由周围结构的感染直接蔓延所致。许多脾脓肿患者会迅速进展为全身性脓毒症，即使及时进行手术并联合抗生素治疗也并非总能治愈。局部症状可能较轻而被忽视，可能仅出现化脓的全身症状。X线检查常常能提供有关脓肿位置的有价值信息。到目前为止，最有前景的技术是使用放射性同位素进行脾扫描。我们描述了阑尾炎后发生脾脓肿的病例。通过肝脾扫描确定了病程和诊断。患者接受了新霉素和氯林可霉素治疗，并切除了患病脾脏。左膈下脓肿引流后，恢复过程顺利。
