Management of Splenic Abscesses
Summary
Splenic abscesses represent a rare but serious suppurative complication within the spleen, often arising through haematogenous spread, contiguous infection or following trauma and interventional procedures. Clinical presentation is typically insidious, with fever, left upper quadrant pain and leukocytosis being the most frequent findings; however, nonspecific manifestations can delay diagnosis. Imaging modalities—particularly contrast-enhanced CT and ultrasonography—are indispensable for early detection and characterisation of abscess number, size and loculation. Management strategies balance systemic antimicrobial therapy with either minimally invasive drainage techniques or surgical intervention. Percutaneous aspiration or catheter drainage under imaging guidance has gained traction for unilocular or small-volume collections, especially in patients with high operative risk or in whom splenic preservation is desirable. Splenectomy remains a definitive option in multifocal, large or refractory abscesses and in cases complicated by haemodynamic instability or rupture. Recent advances have refined patient selection criteria for conservative versus surgical approaches, emphasising individual risk factors, abscess anatomy and underlying comorbidities. A multidisciplinary framework involving infectious disease specialists, interventional radiologists and surgeons ensures optimal outcomes while minimising morbidity and preserving immune function where possible.
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Management of Splenic Abscesses publication trend
The graph below shows the total number of articles in management of splenic abscesses across all publications each year (not limited to Nature Index journals).
Technical terms
Splenic abscess: A localised collection of pus within the splenic parenchyma resulting from infection.
Haematogenous spread: Dissemination of infectious agents through the bloodstream to distant organs.
Percutaneous drainage: A minimally invasive procedure to evacuate fluid or pus using a needle or catheter under imaging guidance.
Contrast-enhanced CT scan: Computed tomography performed with intravenous contrast medium to delineate lesions by improving soft-tissue contrast.
Splenectomy: Surgical removal of the spleen, indicated when abscesses are large, multiloculated or refractory to conservative measures.
References
- Splenic Abscess: An Uncommon Entity with Potentially Life‐Threatening Evolution. Canadian Journal of Infectious Diseases and Medical Microbiology (2018).
- Splenic Abscesses in the Pediatric Population: A Literature Review of an Uncommon Entity. Cureus (2024).
- Splenic abscess due to non-operative management of splenic injury: a case report. Journal of Medical Case Reports (2023).
- Splenic abscess secondary to COVID-19 acute infection: A case report and literature review. Medicine (2024).
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