Background: Nontraumatic splenic acute surgical conditions are rare and challenging conditions for the acute care surgeon. The present chapter will provide an overview on splenic abscesses and nontraumatic splenic ruptures. Results: Splenic abscesses are uncommon and often affect immunocompromised patients; their mortality is relatively high (up to 80%) in immunocompromised patients. The treatment should be tailored on the basis of patients condition, characteristics, and etiology of the abscess and it ranges from nonoperative treatment with broad-spectrum antibiotics to splenectomy. Nontraumatic spleen rupture is also very uncommon: It is due to the presence of splenomegaly and/or the presence of pathologic spleen tissue. Clinical presentation can range from hemorrhagic shock to unspecific symptoms that make very difficult the diagnosis. Nonoperative management should be reserved to low-grade injuries in presence of stable hemodynamics; splenectomy is the treatment of choice in case of high-grade injuries and hemodynamic instability.
Ceresoli, M., Degrate, L. (2023). Spleen Non-traumatic Acute Surgical Conditions. In F. Coccolini, F. Catena (a cura di), Textbook of Emergency General Surgery Traumatic and Non-traumatic Surgical Emergencies (pp. 923-933). Springer [10.1007/978-3-031-22599-4_62].
Spleen Non-traumatic Acute Surgical Conditions
Ceresoli M.Primo
;Degrate L.
2023
Abstract
Background: Nontraumatic splenic acute surgical conditions are rare and challenging conditions for the acute care surgeon. The present chapter will provide an overview on splenic abscesses and nontraumatic splenic ruptures. Results: Splenic abscesses are uncommon and often affect immunocompromised patients; their mortality is relatively high (up to 80%) in immunocompromised patients. The treatment should be tailored on the basis of patients condition, characteristics, and etiology of the abscess and it ranges from nonoperative treatment with broad-spectrum antibiotics to splenectomy. Nontraumatic spleen rupture is also very uncommon: It is due to the presence of splenomegaly and/or the presence of pathologic spleen tissue. Clinical presentation can range from hemorrhagic shock to unspecific symptoms that make very difficult the diagnosis. Nonoperative management should be reserved to low-grade injuries in presence of stable hemodynamics; splenectomy is the treatment of choice in case of high-grade injuries and hemodynamic instability.
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