Isolated splenic abscess
is rare in children, and is more commonly seen in the immunosuppressed and in children with concurrent systemic diseases.
(15) Confirmatory diagnosis is obtained only after histopathologic examination of a splenectomy specimen or acid-fast bacilli (AFB) smear/culture of splenic abscess
are rare, with an estimated incidence of 0.14% to 0.7% of hospitalized patients based on autopsy studies.
One hundred and four patients with a diagnosis of splenic abscess
were reviewed between January 2012 and December 2016, and 16 patients met the criteria for splenic abscess
The management of splenic abscess
used to be splenectomy in the past but with the advent of FNAC splenectomy is avoided.
Similarly, in our report, aspiration of patient 2's splenic abscess
revealed areas of neutrophil-dominant necrosis.
Contrast-enhanced computed tomography of the abdomen (Figure 2) showed two perisplenic hypodense collections of 6.9 x 5.1 x 3.2 cm at the inferior pole and 5.2 x 4.0 x 3.0 cm at the superior pole of the spleen having connections with similar splenic parenchymal collections, suggestive of multiple splenic abscesses
with perisplenic extensions.
Suggested preoperative work-up prior to considering surgery (i) Embolic stroke Initial CT head (ii) Mycotic aneurysm (iii) Intracranial bleed MRI Brain (i) More sensitive for neuroradiological diagnosis (i) Pulmonary Infarcts CT chest, abdomen and pelvis (ii) Splenic and Hepatic Infarcts (iii) Splenic abscess
contraindicating surgery Transesophageal echocardiography (i) More sensitive than TTE in visualization of vegetation (ii) Paravalvular Abscess .
Fever and vomiting was reported in one patient with splenic abscess
. Cysts in our study measured from 2 cms to 13 cms.
Objective: The objective of the study was to review our experience in the management of splenic abscess
in cancer patients at a cancer hospital in Pakistan