Splenic abscess in Jos

Abstract

Background: Splenic abscess is an uncommon surgical condition that constitute 0.14-0.7% of necropsy specimen. Delayed or missed diagnosis may result in a fatal outcome.


Method: A retrospective study of patients with splenic abscess treated at Jos University Teaching Hospital over a ten-year period.


Results: Eight patients were managed. There were 2 males and 6 females aged between 18 and 65 years (median age 31 years). Duration of symptoms ranged between 2 to 16 days with a median of 7 days. The main clinical features were fever, left hypochondriac pain and tender splenomegaly occurring in 87.5%, 100% and 87.5% respectively. Abscess cavity was solitary in seven cases. All except one patient had antibiotics and splenectomy. The commonest organism cultured was staphylococcus aureus, 5 of 7 cultures (71.4%). Postoperative complication included wound infection two, acute pancreatitis one and over- whelming post splenectomy infection (OPSI) in one. There was one mortality (12.5%).


Conclusion: Prompt diagnosis and treatment based on a high index of suspicion will reduce the high morbidity associated with this rare disease. It is hoped that as appropriate skill and imaging techniques become more available in developing countries, more splenic abscess patients will be managed by percutaneus drainage especially that solitary abscess cavity seems dominant in our environment.


(Nig J Surg Res 2003; 27 - 31


Key words: Spleen, abscess, splenectomy