Computed tomography-guided percutaneous drainage of splenic abscesses.
OBJECTIVE
The aim of the study is to evaluate the role of computed tomography (CT)-guided percutaneous drainage in the management of solitary splenic abscesses.


METHODS
Sonography and CT were used in the initial diagnosis of splenic abscess in patients with vague left upper quadrant pain and/or fever. Solitary splenic abscesses of nine male patients whose ages varied between 21 and 27 years (mean age: 24.7 years) were percutaneously drained under CT guidance. Puncture with 18-gauge Chiba needles and coaxial guidewire technique was used for insertion of six or eight French pigtail catheters. Antibiotics in accordance with the microbiological results were also given adjuvant to drainage. Follow-up examinations were performed by sonography, daily for the first week and weekly for the next 7 weeks, and by CT at the end of first, fourth and eighth weeks.


RESULTS
All patients tolerated the intervention well, except for one complicating with splenic rupture and hemorrhage, who underwent emergency splenectomy. The remaining eight patients recovered within 4 weeks without any splenic sequela. A mean of 3.9 days was needed before removing the drainage catheter based on regression criteria.


CONCLUSIONS
CT-guided percutaneous drainage of splenic abscesses may be proven effective and is superior to splenectomy in selected cases, as it preserves host immunity.
Department of Diagnostic Radiology, Gülhane Military Medical School, 06018 Etlik, Ankara, Turkey. mtasar@gata.edu.tr
Mustafa
M
Taşar
Mehmet Sahin
MS
Uğurel
Murat
M
Kocaoğlu
Mutlu
M
Sağlam
Ibrahim
I
Somuncu
D000038:Abscess / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D004322:Drainage / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D012485:Salmonella typhi / Q000302:isolation & purification; D013158:Splenic Diseases / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014435:Typhoid Fever / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D018084:Ultrasonography, Interventional