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Review
. 2023 Dec;94(12):981-986.
doi: 10.1007/s00104-023-01990-y. Epub 2023 Nov 2.

[Diagnostics and treatment of splenic abscesses]

[Article in German]
Hans-Jonas Meyer  1 , Matthias Mehdorn  2
Affiliations
Review

[Diagnostics and treatment of splenic abscesses]

[Article in German]
Hans-Jonas Meyer et al. Chirurgie (Heidelb). 2023 Dec.

Abstract
in English, German

A splenic abscess is a rare disease found in less than 1% of all autopsy studies. Several different diseases are associated as a predisposing factor, such as septic bacteremia due to endocarditis or diverticulitis, previous splenic trauma, immunosuppressive medication or diseases. The reported mortality in the literature is up to 24.5% in correctly diagnosed and treated cases. The diagnostic work-up primarily comprises sonography and computed tomography as well as a percutaneous puncture for determination of the pathogen. In most cases, a percutaneous interventional drainage treatment is sufficient and a splenectomy is necessary only in refractory cases.

Der Milzabszess ist eine seltene Erkrankung, die in weniger als 1 % aller Autopsiestudien diagnostiziert wird. Verschiedene Erkrankungen können als begünstigende Faktoren vorliegen, wie die septische Bakteriämie im Rahmen einer Endokarditis oder Divertikulitis, zurückliegende Milztrauma, immunsuppressive Medikamente oder Erkrankungen. Die beschriebene Mortalität in der Literatur wurde bis zu 24,5 % in korrekt diagnostizierten und therapierten Fällen angegeben. Die diagnostische Abklärung umfasst primär die Sonographie und die Computertomographie sowie die perkutane Punktion zur Erregerbestimmung. In den meisten Fällen ist eine perkutane interventionelle Drainagentherapie zielführend einsetzbar und nur in therapierefraktären Fällen ist eine Splenektomie notwendig.

Keywords: Drainage treatment; Imaging; Mortality; Pathogen determination; Risk factors.

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