Splenic Abscess: Report of Six Cases and Review of the Literature
Splenic Abscess: Report of Six Cases and Review of the Literature
复制标题
脾脓肿六例报告及文献复习
DOI：
--
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发表时间：
2001
期刊：
影响因子：
--
通讯作者：
B. Green
中科院分区：
文献类型：
--
作者：
B. Green
脾脏肿大是罕见的，但似乎是在增加的频率。放射学技术的最新进展影响了诊断和治疗。本研究的目的是评估这些影响。回顾性分析了一个机构的医疗记录，并确定了1989年至1999年期间发生的6例脾脓肿。所有患者均有转移性血行感染的易感条件，其中3例患者有创伤，1例患者有免疫缺陷，1例患者有连续感染部位。所有患者均出现发热，分别有5例和3例患者出现寒战和呕吐。左上腹触痛出现在四个病人和白细胞增多，发现在每一个病人，除了一个与获得性免疫缺陷综合征。胸部X线检查有5例异常，以左侧胸腔积液最为常见。超声检查显示了使用该器械的2例患者的缺损，所有病例的计算机断层扫描均具有诊断性。致病微生物为厌氧菌2例，白色念珠菌、草绿色链球菌、大肠杆菌和弗氏柠檬酸杆菌各1例。在4名患者中尝试了放射学引导的经皮引流，但仅1例成功。脾切除术联合抗生素治疗其余患者，存活率为100%。这些数据表明，经皮引流可能适用于某些患者最初，但高失败率表明，脾切除术仍然是标准治疗。
Splenic abscesses are rare but appear to be increasing in frequency. Recent advances in radiologic techniques have affected the diagnosis and management. The purpose of this study was to evaluate these effects. The medical records of one institution were retrospectively reviewed and six cases of splenic abscesses seen between 1989 and 1999 were identified. All patients had predisposing conditions with metastatic hematogenous infection in three and one each with trauma, immunodeficiency, and a contiguous site of infection. Fever was present in all patients with chills and vomiting in five and three patients, respectively. Left upper quadrant tenderness appeared in four patients and leukocytosis was found in every patient except one with the acquired immunodeficiency syndrome. Chest roentgenograms were abnormal in five patients with a left pleural effusion most common. Ultrasound revealed the defect in both patients it was utilized in and computed tomography was diagnostic in all cases. The causative organisms were anaerobes in two cases and Candida albicans, Streptococcus viridans, Escherichia coli, and Citro-bacter freundii each present in one case. Radiology guided percutaneous drainage was attempted in four patients but was only successful in one. Splenectomy with antibiotics was curative in the remainder with a 100 per cent survival. These data suggest that percutaneous drainage may be appropriate for certain patients initially, but the high failure rate demonstrates that splenectomy remains the standard treatment.
重症监护室的脾脓肿。
DOI：
10.1001/archsurg.1993.01420200016003
发表时间：
1993
期刊：
Archives of surgery (Chicago, Ill. : 1960)
影响因子：
--
作者：
Ho,HS;Wisner,DH
通讯作者：
Wisner,DH