BACKGROUND: Splenic abscess remains a diagnostic challenge with a high mortality rate. Its origin is related to episodes of bacteremia after a splenic infarct. Last decade, the demographics of the population with this disease changed towards patients with immunosuppressive conditions (tuberculosis, cancer, transplant, etc). Traditionally, splenectomy has been the treatment of choice, with a high morbidity and mortality. Percutaneous drainage can be an alternative to avoid splenectomy. METHODS: A direct search of Hospital das Clínicas/UFPE records between November/1993 and February/2004 resulting in a total number of 73094 patients has been perfomed. RESULTS: Seven cases of splenic abscess are presented: five patients were treated with splenectomy and two with percutaneous drainage. Four patients (57%) had splenic abscess related to immunosuppressive conditions (steroids, cancer, tuberculosis and transplant). CONCLUSION: A change in clinical presentation towards imunosupression was observed. The diagnosis should be considered in a patient with fever, abdominal pain and immunosuppressive condition. The percutaneous drainage alone or preceding splenectomy can be efficient to solve splenic abscess in selected cases.
Abscess; Spleen; Splenectomy; Drainage; Infection; Imunosupression; Risk factors; Therapy
