Case Report
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. May 21, 2008; 14(19): 3088-3091
Published online May 21, 2008. doi: 10.3748/wjg.14.3088
Abscesses of the spleen: Report of three cases
Constantin Fotiadis, Giagkos Lavranos, Pavlos Patapis, Gabriel Karatzas
Constantin Fotiadis, Giagkos Lavranos, Pavlos Patapis, Gabriel Karatzas, 3rd Department of Surgery, Attikon University Hospital, Chaidari 12462, Greece
Author contributions: Fotiadis C and Lavranos G contributed equally to this work and wrote the paper; Patapis P and Karatzas G analyzed the data.
Correspondence to: Giagkos Lavranos, Medical Doctor, 3rd Department of Surgery, Attikon University Hospital, 34 Falireos Street, 18547 Neo Faliro, Piraeus 18538, Greece.
Telephone: +30-210-7462350
Fax: +30-210-7462105
Received: November 19, 2007
Revised: March 11, 2008
Published online: May 21, 2008

Abscess of the spleen is a rare discovery, with about 600 cases in the international literature so far. Although it may have various causes, it is most usually associated with trauma and infections of the spleen. The latter are more common in the presence of a different primary site of infection, especially endocarditis or in cases of ischemic infarcts that are secondarily infected. Moreover, immunosuppression is a major risk factor. Clinical examination usually reveals a combination of fever, left-upper-quadrant abdominal pain and vomiting. Laboratory findings are not constant. Imaging is a necessary tool for establishing the diagnosis, with a choice between ultrasound and computed tomography. Treatment includes conservative measures, and surgical intervention. In children and in cases of solitary abscesses with a thick wall, percutaneous catheter drainage may be attempted. Otherwise, splenectomy is the preferred approach in most centers. Here, we present three cases of splenic abscess. In all three, splenectomy was performed, followed by rapid clinical improvement. These cases emphasize that current understanding of spleen abscess etiology is still limited, and a study for additional risk factors may be necessary.

Keywords: Spleen, Abscess, Splenectomy, Infections, Trauma