Successful percutaneous ultrasound-guided drainage for treatment of a splenic abscess.
We report a case of splenic abscess that was successfully treated with percutaneous ultrasound-guided drainage and without splenectomy. A 40-year-old woman was admitted to Nippon Medical School Hospital because of pyrexia and left upper quadrant pain, which had persisted despite antibiotic treatment. On admission, computed tomography demonstrated a low-density area in the spleen, which had been been seen on computed tomography 3 months earlier. Ultrasonography demonstrated a hypoechoic area in the spleen. Initial laboratory tests revealed a serum C-reactive protein concentration of 19.7 mg/dl and a white blood cell count of 15,800 /microl. The serum glucose concentration was 267 mg/dl, and the glycolated hemoglobin value was 7.7%. A splenic abscess was diagnosed and was treated with percutaneous drainage. Milky yellow fluid was obtained, and the patients left upper quadrant abdominal pain and pyrexia resolved. A culture of the drainage fluid yielded Escherichia coli. The drainage catheter was removed 12 days after insertion. The patient was discharged 6 days later. The splenic abscess has not recurred during 3 months of follow-up. Our results suggest that ultrasound-guided percutaneous drainage is a safe and effective alternative to surgery for the treatment of splenic abscess and allows preservation of the spleen.
Kogo
Hideki
H
Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
Yoshida
Hiroshi
H
Mamada
Yasuhiro
Y
Taniai
Nobuhiko
N
Bando
Koichi
K
Mizuguchi
Yoshiaki
Y
Ishikawa
Yoshinori
Y
Yokomuro
Shigeki
S
Akimaru
Koho
K
Tajiri
Takashi
T
D000038:Abscess / Q000000981:diagnostic imaging / Q000601:surgery*; D000328:Adult; D004322:Drainage / Q000379:methods*; D004927:Escherichia coli Infections / Q000601:surgery; D005260:Female; D006801:Humans; D013158:Splenic Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D014463:Ultrasonography