title: Splenic abscess. Imaging and intervention.
abstract: We reviewed the imaging findings of 14 splenic abscesses in 13 patients. All patients underwent chest radiography, 12 ultrasonography (US), 9 CT, 4 plain abdominal radiography, 2 99mTc-HMPAO leukocyte scan and 2 99mTc-HIG scan. Three patients were treated with percutaneous catheter drainage, and 5 with diagnostic or therapeutic fine-needle aspiration (FNA). At US the abscess was hypoechoic (n = 9), anechoic (n = 2), or anechoic with gas-bubbles (n = 1), or the entire spleen was inhomogeneous with gas-bubbles (n = 1). At CT the abscesses appeared as low density (18-30 HU) lesions with (n = 2) or without (n = 7) gas. In 2 cases 99mTc-HMPAO leukocyte scan, and in one case 99mTc-HIG scan showed an intrasplenic defect, and in one case 99mTc-HIG scan was considered normal. At plain abdominal radiography extraintestinal gas was suggested in 2 patients, and the findings were normal in 2. US-guided FNA confirmed infectious etiology of the lesion in 4 patients, and a necrotic specimen suggested infection in one. One patient was cured with repeated aspirations. Catheter drainage was successful in all 3 patients who underwent the procedure. We conclude that US and CT are accurate in detecting splenic abscesses. Our results in splenic interventions advocate wider use of the procedures.
authors.affiliation: Department of Diagnostic Radiology, Oulu University Central Hospital, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Tikkakoski
authors.forename: T
authors.initials: T
authors.lastname: Siniluoto
authors.forename: M
authors.initials: M
authors.lastname: Päivänsalo
authors.forename: M
authors.initials: M
authors.lastname: Taavitsainen
authors.forename: M
authors.initials: M
authors.lastname: Leppänen
authors.forename: K
authors.initials: K
authors.lastname: Dean
authors.forename: M
authors.initials: M
authors.lastname: Koivisto
authors.forename: I
authors.initials: I
authors.lastname: Suramo
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging / Q000628:therapy; D000328:Adult; D000368:Aged; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011877:Radionuclide Imaging; D013158:Splenic Diseases / Q000000981:diagnostic imaging / Q000628:therapy; D014463:Ultrasonography