[Solitary splenic abscess. Clinical picture, diagnosis and treatment]. / L'ascesso splenico solitario. Quadro clinico, diagnosi e trattamento.

ABSTRACT

Splenic abscess, especially the solitary type, is a rarely seen condition, although it has been seen more frequently in recent years. On the basis of a case of splenic abscess with unusual features, the literature on the subject, 171 cases published in Italy, Britain, France and Spain in the past 10 years, is reviewed. It is pointed out that the diagnosis is generally difficult only because abscess is not considered. The diagnostic methods with the best results are ultrasonography and CT scanning, although a checkup after the event showed that straightforward X-ray of the chest, if correctly interpreted, may be enough. Scintigraphy is not indicated and arteriography should only be used in the event of special problems. The clinical picture is scanty and insignificant. The various aetiological agents and changes in these over recent years are illustrated, with special attention with regard to immunodepressed patients. The usual treatment is surgical removal. Other methods with more limited indications, such as drainage and medical treatment, are described.