Jang T N, Fung C P
Department of Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Shih Lin, Taipei, Taiwan, ROC.
J Formos Med Assoc. 1995 Jun;94(6):309-12.
This paper reviews 10 cases of splenic abscess seen from January 1984 to December 1993. Predisposing conditions included preceding pyogenic infections, contiguous infection, trauma, and diabetes. Fever, chills and pain over the left upper quadrant of the abdomen were the most common symptoms. Routine laboratory tests uncovered common abnormalities which included marked leukocytosis and abnormal chest film with left pleural effusion. All 10 patients had a solitary abscess. Enterobacteriaceae and anaerobes were the most common offending organisms and one patient had polymicrobial infections. Nine of the 10 patients were successfully treated with percutaneous sonographically-guided drainage without significant complications. Only one patient underwent splenectomy because of rupture of the splenic abscess into the peritoneal cavity. All 10 patients survived. This review indicates that percutaneous drainage may replace splenectomy as the initial approach in cases of a solitary splenic abscess.
本文回顾了1984年1月至1993年12月间收治的10例脾脓肿病例。诱发因素包括先前的化脓性感染、邻近感染、创伤和糖尿病。发热、寒战和左上腹疼痛是最常见的症状。常规实验室检查发现常见异常，包括明显的白细胞增多和胸部X光片显示左侧胸腔积液。所有10例患者均为单发脓肿。肠杆菌科细菌和厌氧菌是最常见的致病菌，1例患者为混合菌感染。10例患者中有9例通过超声引导下经皮引流成功治愈，无明显并发症。仅1例患者因脾脓肿破裂进入腹腔而接受了脾切除术。所有10例患者均存活。本综述表明，在单发脾脓肿病例中，经皮引流可能取代脾切除术作为初始治疗方法。
