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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Splenic abscess is rare and may be present either as a localized area in the spleen or as part of a generalized sepsis. A 35 year old man presented with a two month history of anorexia, weight loss, fever, abdominal pain and arthralgia. Multiple abscesses localized in the spleen were diagnosed by CT and splenectomy was performed.
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PMID:[Splenic abscess]. 159 71

Splenic abscess is an unusual entity. In the last 30 years at the Johns Hopkins Hospital, only 11 patients have been treated for clinically overt splenic abscess. Generally presenting with fever, leukocytosis, and left-sided upper abdominal pain in the setting of generalized sepsis, the majority had a distant source of bacteremia or an underlying defect in splenic architecture or function. Prior to 1970, diagnosis was one of exclusion, and delay in treatment was frequent. Recently, diagnosis has been facilitated by splenic scintiscans, ultrasonography, and computerized axial tomography. These techniques now afford earlier, objective evidence of splenic involvement. Although splenectomy controls local splenic suppuration, the ultimate prognosis rests on the underlying process predisposing the patient to development of splenic infection.
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PMID:Splenic abscess--presentation, diagnosis, and treatment. 711 99

Splenic abscess, with its rare incidence and various misleading clinical manifestations, usually is a diagnostic pitfall in the modern emergency department. The most frequently seen symptoms and signs are fever, abdominal pain and tenderness over left upper quadrant, splenomegaly, leucocytosis, and left lower chest abnormalities. Four cases were collected during the past five years. On admission, one patient manifested symptoms mimicking a perforated peptic ulcer and the other three patients presented clinical and roentgenographic signs suggestive, but non-specific, for splenic abscess. In two cases, the diagnosis was based on sonography followed by computed tomography (CT). In one case, the splenic abscess was only visualized by CT. They all survived after splenectomy and appropriate antibiotic therapy. Culturing disclosed the offending organisms to be Escherichia coli, Pseudomonas aeruginosa, a Salmonella species, and Streptococcus viridans. These nonspecific clinical pictures should be thoroughly investigated, and CT, the most sensitive diagnostic tool, should be used whenever splenic abscess is suspected. Early diagnosis and timely treatment reduce the morbidity and mortality associated with splenic abscess.
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PMID:Splenic abscess: a diagnostic pitfall in the ED. 775 33

Splenic abscess remains a rare entity, reserved for patients with predisposing factors or immunosuppressive conditions. In our 13 patients in which a splenic abscess was diagnosed pre- or intra-operatively, an average of 14 days past before the diagnosis was made. Main symptoms were fever, upper left abdominal pain, auscultatory left basal anomalies and splenomegaly. Culture from the spleen material included E. coli, Staphylococcus, Proteus, Salmonella and Streptococcus v. Although splenectomy has been considered the standard procedure for this pathology, we treated our last three patients by means of Computed Tomography Percutaneous Drainage (C.T.G.P.D.). There was no need for splenectomy after this procedure and there were no complications associated with the C. T. G. P. D.
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PMID:[Splenic abscess, a diagnostic and therapeutic problem]. 805 Jun 99

Splenic abscess is an infrequent complication in the immunocompromised patient. Six patients underwent splenectomy for presumed splenic abscess from 1987 to 1991. Chemotherapy altered the immune system of four patients; the human immunodeficiency virus (HIV) rendered the other two vulnerable to infection. Five presented with fever but none had leukocytosis; only one exhibited palpable splenomegaly; three had abdominal pain. Cultures documented systemic infection in all but one, an HIV-positive individual. Respiratory embarrassment was the indication for surgery in one patient. In five cases the decision for surgical intervention was made after computed tomography (CT) indicated the presence of multiple splenic lesions and systemic antibiotics failed to resolve the fevers. CT additionally showed hepatic and/or renal microabscesses in four patients. Signs and symptoms experienced preoperatively resolved with splenectomy in all six patients. No additional surgery was required for the patients with extrasplenic abscesses. Surgical pathology determined that three spleens had fungal and two had mycobacterial abscesses. The other was shown to be a spindle cell sarcoma; no abscess was present. This patient had preoperative blood cultures positive for mycobacteria, and the same organism was recovered from retroperitoneal nodes sampled at the time of splenectomy for the sarcoma. Follow-up indicates that no patients experienced surgical complications or sequelae related to their splenic pathology. Splenectomy is necessary and effective in treating splenic abscesses in immunocompromised patients and is appropriate for diagnosis as well as therapy.
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PMID:Management of splenic abscess in immunocompromised children. 833 12

Splenic abscess and retroperitoneal abscess are uncommon, although severe diseases, with a high mortality rate that has been attributed to delayed diagnosis, due to the unspecificity of clinical symptoms. We report two patients with a splenic and a retroperitoneal abscess, respectively, in both cases as an onset of colon cancer. The two patients complained of abdominal pain and fever as onset symptoms. Abdominal ultrasonography was normal in the case of retroperitoneal abscess and abnormal in the case of splenic abscess. CT Scan was diagnostic in both cases. In the patient with splenic abscess. CT Scan established a further diagnostic suspect of colon cancer, which was confirmed by colonoscopy. In the patient with retroperitoneal abscess, diagnosis of colon carcinoma was made during the surgical act. In spite of an adequate, combined medical and surgical therapy, both patients died within a short time after surgery.
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PMID:[Intra-abdominal abscess as presentation of colonic cancer]. 1073 Apr 3

Splenic abscess is a rare complication of thalassemia major. In this paper we report a 10-year-old male thalassemic child with splenic abscess. He presented with high-grade fever, abdominal pain and tender splenomegaly. The diagnosis was confirmed by ultrasonography and computerized tomography scan of the abdomen. The patient underwent emergency splenectomy.
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PMID:Splenic abscess in childhood B-Thalassemia Major. 1193 32

Splenic abscess is an unusual and potentially life-threatening disease. Due to the nonspecific clinical picture, it remains a diagnostic challenge. Splenic abscess should be suspected in febrile patients with left upper quadrant tenderness and leukocytosis, and diagnosis confirmed based mostly on imaging studies, microbiologic and / or pathologic evidence, or by response to antibiotic or antifungal treatment. We present 29 cases of splenic abscess treated in our hospital from 1990 to 2001. There were 18 male patients (62%) and 11 female patients (38%). Ages ranged from 4 to 85 years, with a median of 44 years. There were five pediatric patients (17%) and 24 adults (83%). The most common associated condition was leukemia. Most patients were immunocompromised (72%). The more common signs and symptoms were fever (90%), chills (41%), abdominal pain (31%), and leukocytosis (38%). Ultrasonography of the abdominal cavity was positive in 27 cases (93%); computerized tomography or magnetic resonance imaging was used in 26 patients (90%) and was positive in all patients. The abscess was solitary in 21 cases (72%) and multiple in eight cases (28%). Positive blood cultures were found in only seven patients (24%). According to the literature, the treatment of choice is still splenectomy, but in our study, the success rate of 75% with antibiotics alone indicates that antibiotic therapy should be considered an important alternative treatment modality in patients not suitable for percutaneous drainage and splenectomy.
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PMID:Splenic abscesses: review of 29 cases. 1462 Jun 77

Splenic abscess are a rare and severe pathology causing difficulty in diagnosis and treatment. The Clinical presentation usually associated with abdominal pain in the left upper quadrant, fever and splenomegaly. Diagnosis will be confirmed by morphologic examination such as ultra sonography and computed tomography. Percutaneous drainage procedure made in first intention can be used either for curative purpose or to prepare patient for surgery. We report four cases of splenic abscess collected in our departement between 1997 and 2000 in which percutaneous drainage procedure was trial first. Two of them were successful and the others were completed by splenectomy.
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PMID:[Splenic abscess: from diagnosis to treatment]. 1512 60

Splenic abscess is a rare clinical entity, and splenectomy remains the treatment of choice. We sought to determine the safety and efficacy of laparoscopic splenectomy in this setting. Using a prospective database of laparoscopic splenectomy, we identified 4 patients who underwent surgery for splenic abscess (3 male, 1 female). Mean age was 55.5 (range 42-78) years. Patient symptoms included: fever and abdominal pain in 4 patients, pleural effusions in 2, and nausea and leukocytosis in 1. Risk factors for splenic abscess included septic emboli from bacterial endocarditis in 2 patients and acquired immune deficiency syndrome in 1. All patients underwent successful laparoscopic splenectomy. Mean operative time was 200 (range 160-220) minutes, and blood loss was 220 (range 100-450) mL. There were no postoperative complications or deaths; postoperative length of stay averaged 14 (range 2-26) days. Despite the difficulty of the operation, the laparoscopic approach appears to be a safe and effective treatment of splenic abscess.
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PMID:Laparoscopic splenectomy for splenic abscess. 1549 61


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