Splenic abscesses: 6 cases in 15 years

Splenic abscesses are a rare type of disease, owing to the quite exceptional primary forms, but the prevalence of the disease is rising as a result of the increase in the population at risk. The authors report on their experience based on 6 observations of such cases over a period of 15 years. The diagnosis was obtained by ultrasonography in all 6 cases. Only one case was successfully treated by percutaneous drainage, the other 5 all requiring splenectomy. Only one patient, suffering from Chédiak-Higashi disease, died of bronchopneumonia 6 months postoperatively. Nowadays the disease is diagnosed earlier than it was in the past owing to the increasingly widespread use and refinement of diagnostic methods, but even today identification of splenic abscess may still be late due to the presence of predisposing diseases which mask the clinical picture, and also because, since the condition is so rare, one very often fails to think of it in the early stages. An analysis of the recent literature indicates that percutaneous drainage is a reliable technique which presents a high therapeutic success rate and low cost compared to surgery. Though we believe that the ongoing progress in the fields of ultrasonography and CT-guided intervention may allow us to treat increasing numbers of patients with splenic abscesses in future, we feel, also in the light of our own experience, that splenectomy still remains the reference treatment, in that ideal conditions for successful percutaneous drainage do not often present themselves.