[Abscesses of the spleen. Value of echoguided percutaneous drainage apropos of 4 new cases].
Curative treatment in 4 patients with splenic abscesses was obtained after echoguided percutaneous drainage. An analysis of the literature from 1986 to 1992 revealed that both splenectomy (87 cases) and percutaneous drainage (47 cases) have had their indications. This could appear rather surprising since that in 1986 several reports had already indicated the safety and effectiveness of percutaneous drainage which leads to cure in 70% of the cases and reduces both the cost of the surgical procedure and he long-term risks of splenectomy. The analysis of the recent literature would suggest, with certain reservations related to the nature of this type of analysis, that percutaneous drainage is a superior technique compared with splenectomy. Mortality reported after splenectomy was high (14%) compared with mortality after percutaneous drainage (2%) (1 out of 47 cases). Percutaneous drainage was unsuccessful in 5 patients (11%) who then underwent successful splenectomy. Global cure rate for percutaneous drainage alone was 87%. Based on the results of this analysis of the data in the literature, and on our own personal experience, we conclude that splenectomy should be performed only exceptionally for splenic abscesses, usually in cases with multifocal abscesses or complicated with rupture.
Avisse
C
C
Service de Chirurgie Générale et Digestive, CHU, Hôpital Robert Debré, Reims.
Delattre
J F
JF
Ouedraogo
T
T
Beguinot
I
I
Bensabbah
F
F
Bouche
O
O
D000038:Abscess / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D000368:Aged; D004322:Drainage; D006801:Humans; D008297:Male; D008875:Middle Aged; D012480:Salmonella Infections / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D013158:Splenic Diseases / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
Les abcès de la rate. Intérêt du drainage percutané échoguidé à propos de quatre nouveaux cas.