Splenic abscess in children with sickle-cell disease

Al-Salem, Ahmed H.; Mallapa, Kolar Kadappa; Qaisaruddin, Syed; Al‐Jam'a, Ali H.; Elbashir, Ali

doi:10.1007/bf00179448

Cited by 14 publications

(18 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Splenic abscess is generally uncommon, but in patients with SCD there is a high incidence of splenic infarction in addition to the opportunity for bacteremia, especially in the presence of functional asplenia which renders these patients prone to developing splenic abscess. 20,25 This is often due to Salmonella. 20,25 Whereas percutaneous abscess drainage has been effective in treating splenic abscess in children and adults, [26][27][28] the presence of functional asplenia in these patients makes them prone to recurrent infections, and splenectomy together with prophylactic pneumococcal vaccination and antibiotics is the treatment of choice.…”

Section: Discussionmentioning

confidence: 99%

“…20,25 Whereas percutaneous abscess drainage has been effective in treating splenic abscess in children and adults, [26][27][28] the presence of functional asplenia in these patients makes them prone to recurrent infections, and splenectomy together with prophylactic pneumococcal vaccination and antibiotics is the treatment of choice. 20,25 In conclusion, ultrasonography is a simple, safe, reliable, accurate, and repeatable method of assessing splenic size in patients with sickle cell disease, and it is devoid of radiation. The presence of splenomegaly in these patients should be correlated with function using either the pocked red cells method or splenic uptake of 99m Tc sulfur colloid.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Sonographic Assessment of Spleen Size in Saudi Patients with Sickle Cell Disease

Al-Aithan

Bhamidipati

et al. 1998

Ann Saudi Med

View full text Add to dashboard Cite

Background:In patients with SCD, the spleen commonly enlarges during the first two decades of life but then undergoes autosplenectomy due to repeated attacks of vaso-occlusion and infarction. This, however, is not the case in Saudi patients with SCD, where splenomegaly sometimes persists into adult life. Patients and Methods: Ultrasonography was used to evaluate spleen size in 363 Saudi patients with SCD (340 SCD and 23 sickle ß-thalassemia). A total of 363 patients were evaluated. Their ages ranged from 1-60 years (mean 16 years). Results: Only 24 (6.6%) of our patients had autosplenectomy. The splenic index increased with age until about 40 years of age and then gradually decreased, indicating persistence of splenomegaly in our patients into an older age group. Forty-three patients (11.8%) had marked-massive splenomegaly (splenic index >120 cm) and these had higher HbF levels (mean HbF=22.2%) when compared with those who had autosplenectomy (mean HbF=14.6). This is significant (P-value=0.0169) and confirms the effect of HbF on persistence of splenomegaly in SCD patients. Conclusions: Ultrasonography is a simple, safe and accurate method of assessing splenic size in patients with sickle cell disease. Patients with persistent splenomegaly should be followed closely for development of complications which may necessitate splenectomy.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sonographic Assessment of Spleen Size in Saudi Patients with Sickle Cell Disease

Al-Aithan

Bhamidipati

et al. 1998

Ann Saudi Med

View full text Add to dashboard Cite

show abstract

“…39,40 The clinical presentations of splenic abscess are not specific, and a high degree of clinical awareness is essential for early diagnosis. 41 The classic presentation is that of fever, abdominal pain and tender splenomegaly.…”

Section: Splenic Abscessmentioning

confidence: 99%

“…41 The classic presentation is that of fever, abdominal pain and tender splenomegaly. 40 Radiographic signs of splenic abscess on abdominal x-ray include extraintestinal gas in the left upper quadrant, left upper quadrant soft tissue mass displacing the gastric air bubble, and downward displacement of the left kidney. The chest radiograph may show elevation of the left hemidiaphragm, left basal atelectasis, pneumonia and left pleural effusion.…”

Section: Splenic Abscessmentioning

confidence: 99%

“…We found computerized tomography to be more reliable, as it allows more accurate anatomical localization. 39,40 Many organisms can cause splenic abscess, but the most frequently encountered organisms are Staphylococcus aureus, Streptococci and gram-negative bacilli. Other less common organisms include anaerobes, Mycobacterium tuberculosis and Serratia marcescens.…”

Section: Splenic Abscessmentioning

confidence: 99%

See 1 more Smart Citation

The Role of Splenectomy in Patients with Sickle Cell Disease

Al-Salem

1997

Ann Saudi Med

View full text Add to dashboard Cite

Splenic abscess and sickle cell disease

et al. 1998

View full text Add to dashboard Cite

This is a report of our experience with 10 cases of splenic abscess in patients with sickle cell disease (SCD). All presented with fever and abdominal pain and were found to have a tender enlarged spleen. Two were found to have a ruptured spleen and five of them were septicemic on presentation. Although both ultrasound and CT-scan of the abdomen were of diagnostic value, we found CT-scan more accurate and reliable in the diagnosis of splenic abscess. Ultrasound and/or CT-scan should be used routinely in the evaluation of SCD patients who present with fever and abdominal pain, especially if they have a tender enlarged spleen. Diagnostic aspiration under CT-scan or ultrasound guidance should be used in doubtful cases to differentiate between splenic abscess and a large splenic infarct. All our patients were managed by peri operative antibiotics and splenectomy with no mortality. Salmonella was the commonest causative organism. Although CT-guided aspiration of splenic abscess is being advocated recently, we feel splenectomy should be the treatment of choice in patients with SCD as there is no point in preserving a non-functioning spleen that is present in the majority of patients. CT-guided aspiration may be employed as a temporary measure for those patients who are at high surgical risk with unilocular abscess. Am.

show abstract

Splenic abscess in children with sickle-cell disease

Cited by 14 publications

References 10 publications

Sonographic Assessment of Spleen Size in Saudi Patients with Sickle Cell Disease

Sonographic Assessment of Spleen Size in Saudi Patients with Sickle Cell Disease

The Role of Splenectomy in Patients with Sickle Cell Disease

Splenic abscess and sickle cell disease

Contact Info

Product

Resources

About