Changing clinical spectrum of splenic abscess

In two thirds the patients with splenic abscess, the infection develops as a terminal manifestation of uncontrolled disease of other organs. These patients often have multiple small abscesses that usually produce no special clinical manifestations. Even if the existence of splenic sepsis were known, splenectomy would not benefit most of these patients. In one third the patients, pain and tenderness in the left upper quadrant of the abdomen direct attention to the spleen as the source of sepsis. Diagnosis can be confirmed by splenic scanning or arteriography and the patient can be cured by splenectomy. Contiguous infection and intravenous drug abuse are the most common causes of these curable solitary abscesses.