[Splenic abscess--etiologic, clinical and diagnostic features].
The aim of the study is to elucidate premorbid grounds, diagnostic and clinical peculiarities, as well as medical and surgical management of non-parasitic spleen abscess. We study 6 cases, with median age 56.7 years, men/women ratio--2:1. Onset-diagnosis period was of median 20 days. In 5 cases (83.3%) spleen abscess developed in immune compromised patients (diabetes mellitus, liver cirrhosis, pancreatitis) and in one case (16.7%) subsequent to blunt abdominal trauma. Clinically, patients presented fever, weight loss and pain in the left upper quadrant of the abdomen. The imaging data (USG, CT, and Rx-thoracic) performed prior to surgery confirmed the diagnosis. USG revealed splenic injury in 80%, CT had a 100% sensibility and thoracic Rx revealed left-side pleuro-pulmonary reaction in 83% of cases. Bacteriological test was positive in 50% of cases. One death was recorded in first 24 hours after surgery. The rest of the cases had a favorable evolution, although, in 2 cases a left subphrenic abscess was noticed, one requiring drainage; in one case--colonic fistula, which closed spontaneously. Although, it's a rare pathology, an early diagnosis is as important, as impossible, and it's delay exhausts the organism and increases the postoperative morbidity rate, splenectomy remaining the safest method of treatment.
Clinica Chirurgie N1 Nicolae Anestiadi şi Laboratorul Chirurgie Hepato-Pancreato-Biliară, Universitatea de Stat de Medicină şi Farmacie Nicolae Testemitanu, Spitalul Clinic Municipal de Urgenţă, Chişinău, Moldova.
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Ghidirim
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Rojnoveanu
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Mişin
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Gagauz
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Gurghiş
D000007:Abdominal Injuries / Q000150:complications; D000038:Abscess / Q000175:diagnosis* / Q000209:etiology* / Q000382:microbiology / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D004322:Drainage; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013154:Spleen / Q000293:injuries; D013156:Splenectomy; D013158:Splenic Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000382:microbiology / Q000401:mortality / Q000601:surgery; D016019:Survival Analysis; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000150:complications