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Splenic abscesses in the new millenium – a systematic review
Background Isolated splenic abscesses are rare, but increasingly reported with newer organisms and changes in mechanisms involved. We conducted a comparative review of publications from 1900–1977, 1977–1986, 1987–1995, and 1996–2022. Methods A systematic search in Embase and PubMed resulted in 522 p...
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Published in: | ANZ journal of surgery 2024-10, Vol.94 (10), p.1702-1709 |
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Main Authors: | , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites |
Online Access: | Get full text |
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Summary: | Background
Isolated splenic abscesses are rare, but increasingly reported with newer organisms and changes in mechanisms involved. We conducted a comparative review of publications from 1900–1977, 1977–1986, 1987–1995, and 1996–2022.
Methods
A systematic search in Embase and PubMed resulted in 522 publications (1111 cases). Data was tabulated, analysed, and compared.
Results
Patient demographics and symptoms remain unchanged although more Asian patients were reported. Metastatic infections remain the main cause, but COVID‐19‐linked and iatrogenic causes post bariatric surgery and splenic artery embolization are increasingly reported. Aerobic organisms remain the commonest (68%), with a variety of exotic organisms reported. Splenectomy remains the definitive treatment, although antibiotics only and percutaneous aspiration/catheter‐drainage are increasingly used with reasonable outcomes, with salvage splenectomy for therapeutic failures not having significantly higher mortality than upfront splenectomy.
Conclusions
Isolated splenic abscesses continue to be uncommon, with diagnosis requiring a high degree of suspicion. Non‐surgical options for treatment can sometimes be definitive.
Splenic abscesses are increasingly being reported with newer organisms and following interventions. Non‐surgical treatment options now offer reasonable outcomes, with salvage splenectomy results not that much worse than definitive splenectomy upfront. |
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ISSN: | 1445-1433 1445-2197 1445-2197 |
DOI: | 10.1111/ans.19178 |