Original Article DOI 10.3349/ymj.2011.52.2.288 pISSN: 0513-5796, eISSN: 1976-2437 Yonsei Med J 52(2):288-292, 2011 Splenic Abscess: A Single Institution Study and Review of the Literature Won-Suk Lee, Sang Tae Choi, and Keon Kuk Kim Department of Surgery, Gachon University of Medicine and Science, Gil Hospital, Incheon, Korea. Received: June 7, 2010 Revised: July 12, 2010 Accepted: July 12, 2010 Corresponding author: Dr. Keon Kuk Kim, Department of Surgery, Gachon University of Medicine and Science, Gil Hospital, 1198 Guwol-dong, Namdong-gu, Incheon 405-760, Korea. Tel: 82-32-460-8303, Fax: 82-32-460-3009 E-mail: kimkk@gilhospital.com ∙ The authors have no financial conflicts of interest. © Copyright: Yonsei University College of Medicine 2011 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non- Commercial License (http://creativecommons.org/ licenses/by-nc/3.0) which permits unrestricted non- commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose: The aim of this study was to review our experience with splenic abscess- es, with respect to the relevant aspects of splenic abscesses and treatment out- comes. Materials and Methods: We reviewed the cases of 18 patients who had splenic abscesses and who were treated at our hospital from November 1993 to December 2008. Results: The most common symptom at presentation was ab- dominal pain in 12 patients (66.7%). The median duration from symptom onset until establishment of a diagnosis was 22 days. Streptococcus viridians was the most common pathogen (27.8%), follow by Klebsiella pneumoniae (22.2%). The mortality rate during the inpatient period and the previous 90 days was 16.6%. Three of four patients with Klebsiella pneumoniae showed a single abscess pocket. Four patients (22.2%) underwent percutaneous drainage, eight (44.5%) recieved antibiotic treatment only and six (33.3%) underwent splenectomy. Conclusion: There is no gold standard for treating splenic abscesses. Treatment should be cus- tomized for each patient. Key Words: Abscess, infection, spleen INTRODUCTION Splenic abscess is an uncommon disease, and it has been noted to occur at a rate of 0.14% to 0.7% in autopy studies.1,2 Splenic abscesses generally occur in patients with neoplasia, immunodeficiency, trauma, metastatic infection, splenic infarct or diabetes.3 The incidence of splenic abscess is thought to be growing, due to the in- creasing number of immunocompromised patients who are particularly at risk for this disease, and also due to the widespread use of diagnostic imaging modalities such as computated tomography (CT) and ultrasonography (US).4-7 The manage- ment of splenic abscess is based on medical therapy with antibiotics and splenec- tomy or percutaneous drainage (PCD), with good results.8-10 However, the optimal treatment remains unclear. While it is recognized that PCD may be appropriate for some patients, a high failure rate (14.3-75%) has been observed for this procedure, and surgery remains the goldstandard treatment.3-8,11-14 The purpose of this study was to review our experience with splenic abscesses. We specifically examined the relevant aspects of splenic abscesses and the treatment outcomes. 288 Yonsei Med J http://www.eymj.org Volume 52 Number 2 March 2011