-Case Reports-

Successful Percutaneous Ultrasound-guided Drainage for Treatment of a Splenic Abscess

Hideki Kogo, Hiroshi Yoshida, Yasuhiro Mamada, Nobuhiko Taniai, Koichi Bando, Yoshiaki Mizuguchi, Yoshinori Ishikawa, Shigeki Yokomuro, Koho Akimaru and Takashi Tajiri

Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School

We report a case of splenic abscess that was successfully treated with percutaneous ultrasound-guided drainage and without splenectomy. A 40-year-old woman was admitted to Nippon Medical School Hospital because of pyrexia and left upper quadrant pain, which had persisted despite antibiotic treatment. On admission, computed tomography demonstrated a low-density area in the spleen, which had been been seen on computed tomography 3 months earlier. Ultrasonography demonstrated a hypoechoic area in the spleen. Initial laboratory tests revealed a serum C-reactive protein concentration of 19.7 mg/dl and a white blood cell count of 15,800/μl. The serum glucose concentration was 267 mg/dl, and the glycolated hemoglobin value was 7.7%. A splenic abscess was diagnosed and was treated with percutaneous drainage. Milky yellow fluid was obtained, and the patient's left upper quadrant abdominal pain and pyrexia resolved. A culture of the drainage fluid yielded Escherichia coli. The drainage catheter was removed 12 days after insertion. The patient was discharged 6 days later. The splenic abscess has not recurred during 3 months of follow-up. Our results suggest that ultrasound-guided percutaneous drainage is a safe and effective alternative to surgery for the treatment of splenic abscess and allows preservation of the spleen.

J Nippon Med Sch 2007; 74: 257-260

Keywords
splenic abscess, percutaneous drainage, spleen preservation, diabetes

Correspondence to
Hiroshi Yoshida, MD, Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
hiroshiy@nms.ac.jp

Received, March 1, 2007
Accepted, April 18, 2007