Jamshed Akhtar, Parveen Tariq, Javed Ahmed, Ijaz Hussain, Abdul Aziz.
Splenic Abscesses in Children.
J Coll Physicians Surg Pak Jan ;9(3):158-9.

Splenic abscesses are rare in children. Two patients presented with pain in left upper quadrant of abdomen and fever. On investigations single splenic abscess was found in one and in another splenic abscess with perisplenic collection were noted. The patient with solitary abscess responded well to antibiotic therapy alone. In other patient chemotherapy failed to resolve abscess and splenectomy was undertaken. Histopathology of the specimen revealed tuberculosis. Failure of response to antibiotic treatment demands early surgical intervention in order to decrease morbidity and mortality.

CASE REPORT: A nine years old male child weighing 22 kg presented in August 1998 with high grade fever of 3 days duration. There were no associated complaints at that time but over ensuing days he developed excruciating pain in left hypochondrium. On clinical examination patient was healthy looking. Marked tenderness was present in left hypochondrium. Ultrasound was done which showed enlarged spleen with hypoechoic area measuring 3.9 x 3.8 cm suggestive of an abscess. X-ray chest was normal. Hepatosplenic scan showed a normal size spleen with a cold area. Patient was put on antibiotic (cloxacillin) and antipyretic. General condition of the patient started improving and clinical examination done in following week revealed palpable spleen (3 cm) in left hypochondrium which was mildly tender. In four weeks time fever subsided and pain disappeared. Ultrasound repeated in following weeks showed gradual decrease in the size of lesion. Hypoechoic area disappeared completely in 2 1/2 months.

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