2 cases of splenic abscess in clinical diagnosis and surgical treatment.docVIP

 PAGE \* MERGEFORMAT 6 2 cases of splenic abscess in clinical diagnosis and surgical treatment [Keywords:] diagnosis and treatment of splenic abscess A case report Case 1: Female, 58 years old, his left upper abdominal pain with persistent fever of more than six months, in March 22, 1999 admission. After the onset of treatment in many hospitals, long application of a variety of antibiotic treatment, no significant effect. Search body: body temperature 38.4 , pulse 92 / min, breathing 26 times / min, blood pressure 14/10 kPa. sickly pain, chronic consumption of physical fitness, flat belly, left upper quadrant tenderness, no rebound tenderness, mild abdominal strain locally, left rib cage under the touch of a mass, tenderness, surface uneven, without notch. B Super, CT, MRI examination revealed the spleen increase, loss of normal shape, the fluid within the visible image. a clinical diagnosis of splenic abscess. The short-term antibiotics and systemic support treatment, splenectomy. intraoperative exploration found: splenomegaly, about 20 cm 18 cm 18 cm, with extensive adhesions around the spleen ligament resolution is unclear, there is the door near the spleen 5 cm 6 cm cystic mass with thick white pus out of the puncture, separation around the adhesions, splenic pedicle conventional treatment, removal of the spleen, the spleen nest clean, see the diaphragm top 6 cm 7 cm necrotic area, not through the chest, placed drainage, body temperature returned to normal after 4 d, 15 d were discharged hospital. histopathological diagnosis of multiple splenic abscess. Case 2: Female, 37 years old, sudden chills, fever 3 d on February 13, 2002 into the hospital medicine, examination: body temperature 39 , pulse 100 / min, breathing 28 times / min, blood pressure 13 / 9 kPa, weight loss, facial flushing, abdominal soft, slight pressure of the left upper quadrant pain, no rebound tenderness, no muscle health, and antibiotic treatment 6 d, but not alleviate th