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Spleen Abcess – CT ImagingKristianto Budi Wibowo
Radiology Dept Faculty of Medicine Gadjah Mada University
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Anatomy
THIEME - Atlas of Anatomy
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Anatomy of Spleen
THIEME - Atlas of Anatomy
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Abnormalities of Spleen Congenital Trauma Infection Malignancy Vascular Misc
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Spleen Abcess Epid : rare 0.05-0.7% , high mortality Etiology :
- Hematogenic Spread >>- Infected Trauma- Infected spleenic infarction- Alcoholism,DM,Immunosupressan >>
Pathophysiology- Hematogenous embolization- Spread from altered splenic architecture- Contiguous spread http://emedicine.medscape.com/article/194655-
overview#a0104
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Clinical Presentations Fever Abdominal Pain (punctum maximum
in the left hypochondrium ) Shoulder pain (Involvement of the
diaphragmatic pleura ) Pleuritic chest pain General malaise Dyspeptic symtoms
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Imaging Plain photo US CT MRI
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Computed Tomography NECT :
- Low attenuation, ill-defined lesion within splenic parenchyma
- May rarely contain gas bubbles or air-fluid levels
CECT: - Low attenuation, nonenhancing complex fluid
collection- May extend to subcapsular location
Diagnostic Imaging : Abdomen
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Pyogenic splenic abscess on CECT. Note low attenuation abscess bulging splenic parenchyma (arrow).
Pyogenic splenic abscess on axial CECT.Note thin septations within abscess (arrows)
CECT
Diagnostic Imaging : Abdomen
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NECT
Nonenhanced CT scan shows a 6-cm hypoattenuating mass within the spleen (large arrow), with inflammatory soft tissue stranding in the adjacent extraperitoneal fat (small arrow)
RadioGraphics 1994; 14:307-332
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Microabcess of Spleen
Axial CECT of fungal microabscesses. Note : numerous hypodense lesions.
Axial CECT demonstrates splenic microabscesses. Note small < 1 cm lesions diffusely throughout the spleen.
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Resume Anatomy Abnormalities of Spleen Spleen Abcess Clinical Presentations Imaging modalities CT findings
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QuizAn 62-year-old diabetic male with multiple medical problems was referred to the hospital because of 2 weeks of fever unresponsive to empirical antibiotic treatment. Because of an abnormal chest x-ray, the patient underwent CT scan. Herein the result of the examination.1. Please describe this picture2. What is the most likely diagnosis
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Thank You