With less than 1000 cases described globally, abscess of the spleen constitutes an infrequent disease. Difficult to diagnose, the disease carries a high morbidity and mortality rate when it remains undiagnosed, since it has a predisposition for immunocompromised patients. Furthermore, with the advent of non-operative management of splenic trauma, less splenectomies are performed using embolization, potentially giving rise to the formation of a splenic abscess. Therefore, it is important that surgeons are familiar with this disease and treat it accordingly. The aim of this article is to review the pathogenesis, epidemiology, diagnostic modalities and methods of treatment for this disease. Different imaging modalities facilitate diagnosis, with computed tomography being the cornerstone. Splenectomy remains the mainstay of treatment, although encouraging results of more conservative methods have been reported. Splenic abscess is relevant to the differential diagnosis of febrile surgical disease and should be suspected when the surgeon is confronted with patients complaining of fever and pain in the left subcostal region, especially when they are under some form of immunosuppression. PathophysiologyFungal splenic abscesses are multiloculated in 90%

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Background-Aim: Hepatic abscess secondary to intrahe-patic gallbladder perforation is very rare and only few cases are published in the literature. Methods: We present our experience of management of three cases of liver abscesses secondary to intrahepatic gallbladder perforation. All the patients manifested right upper quadrant abdominal pain and fever, accompanied by chills and vomiting in the first patient, by septic shock in the second and by general weakness in the third patient. In all three patients, liver abscess was diagnosed by sonography and computer tomography scanning, and attributed to intrahepatic perforation of the gallbladder. All patients underwent cholecystectomy and drainage of the liver abscess, preceded by percutaneous abscess drainage in one patient. Results: The postoperative period was not uneventful, resulting in two patients being discharged on the 28th and 33nd postoperative day, while the third patient died on the 27th postoperative day owing to sepsis. Conclusion: Liver abscesses secondary to intrahepatic gallbladder perforation is a serious illness that must be managed immediately by cholecystectomy and abscess drainage, while concomitant diseases should also be addressed. Furthermore, the mortality and morbidity rates are high primarily because of delayed diagnosis.

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