Spleen Abcess – CT ImagingKristianto Budi Wibowo

Radiology Dept Faculty of Medicine Gadjah Mada University

Anatomy

THIEME - Atlas of Anatomy

Anatomy of Spleen

THIEME - Atlas of Anatomy

Abnormalities of Spleen Congenital Trauma Infection Malignancy Vascular Misc

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

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

Imaging Plain photo US CT MRI

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

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

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

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.

Resume Anatomy Abnormalities of Spleen Spleen Abcess Clinical Presentations Imaging modalities CT findings

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

Thank You