Splenic abscess following blunt abdominal trauma

Abstract

A rare case of splenic abscess occurring after blunt abdominal trauma in a previously healthy boy is reported. The diagnosis was made by ultrasonography. The patient recovered after splenectomy and drainage of subphrenic and intraperitoneal pus.

Delayed splenic abscess after blunt abdominal trauma in the 24- year-old woman: diagnostic difficulties and dilemma

“…The most clinical presentation of patients with splenic abscess is a classical triad of fever, left upper quadrant pain and splenomegaly [6]. Kumar et al reported a case of splenic abscess in a healthy boy after abdominal blunt trauma who presented with fever and ultrasound detected the splenic abscess, however our patient had not had fever and ultrasound findings were not suggestive of splenic abscess [7]. Also, in our patient in the first and second ultrasound examination no increasing in size of spleen was detected.…”

“…Percutaneous drainage has been suggested as the first line of treatment to avoid splenectomy [6]. Although multilocular abscesses, necrotic debris and illdefined cavities seems to be not responsive to percutaneous drainage and surgery intervention is necessary [6][7][8][9][10].In our patient ambiguity in the accurate detection of splenic abscess leads to early surgery intervention. Open splenectomy is a standard choice of treatment of splenic abscess with a mortality rate of 0-17%, but laparoscopic splenectomy is also a safe method in selected patients [5,6].…”

Primary splenic abscess requiring splenectomy

“…It is less invasive and less costly than surgery. The success of percutaneous drainage depends on the morphology and localization of the abscess . In our patient, the initial treatment with intravenous antibiotics was unsuccessful.…”

“…The incidence of splenic abscess ranges from 0.2 to 0.7% in population‐based autopsy studies . The predisposing factors for splenic abscess include immunosuppression, diabetes mellitus, presence of infections at different primary sites, haematological disorders, malignancy and trauma . Intravenous drug users and alcoholics have shown an increased incidence in comparison with other groups .…”

“…The clinical features of splenic abscess include LUQ pain, fever, splenomegaly and left‐sided pleural effusion . CT scan is more reliable than ultrasonography in confirming the diagnosis . The most common microbes involved in splenic abscess include staphylococci, streptococci, salmonella and Escherichia coli .…”