Splenic abscess: Outcome and prognostic factors

Abdul Rehman Alvi, Shazia Kulsoom, Ghina Shamsi

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)

Abstract

Objective: To determine the spectrum of presentation, treatment outcome and prognostic factors of splenic abscess in a tertiary care hospital. Study design: Case-series. Place and duration of study: Department of General Surgery, the Aga Khan University Hospital, Karachi, from July 1988 to July 2007. Methodology: The records of 27 patients with splenic abscess, diagnosed from 1988 to 2007, were retrieved through ICD-10 coding system. The demographic data, physical and radiological findings, treatment modalities, bacteriology reports, morbidity and mortality were collected on a proforma. Results: There were 12 males and 15 females with a mean age of 43.52±17.49 years. Common symptoms were fever (92.6%), abdominal pain (55.6%) and malaise (29.6%). Majority of patients (89%) had leukocytosis and 63% patients had associated diseases with which they were admitted. The most common pathogenic organism was Staphylococcus species and gram-negative rods. Ultrasound was used as a preliminary diagnostic modality, which was often followed by CT scan. Thirteen patients were treated with intravenous antibiotics, 8 underwent percutaneous drainage and 6 patients required splenectomy with respective survival rates of 84%, 87.5% and 83%. Mortality rate was 14.81% but no statistically significant difference between 3 treatment groups was manifested. There was significant difference between treatment groups regarding the size of the abscess (p=0.01) and hospital stay (p=0.04). Splenectomy was done when abscess size was > 10cm and hospital stay were increased in the radiological drainage group. Conclusion: Splenic abscess is an uncommon surgical entity. High index of suspicion and liberal use of radiological studies is essential for timely diagnosis. Most of the patients could be cured with non-operative treatment. Splenectomy is a safe procedure for patients with abscess size more than 10 cm and patients not responding to non-operative treatment.

Original languageEnglish
Pages (from-to)740-743
Number of pages4
JournalJournal of the College of Physicians and Surgeons--Pakistan : JCPSP
Volume18
Issue number12
Publication statusPublished - Dec 2008

Keywords

  • Splenectomy aspiration
  • Splenic abscess

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