[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.
Ghidirim
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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.
Rojnoveanu
Gh
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Mişin
I
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Gagauz
I
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Gurghiş
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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