Abstract
We report a case of splenic abscess in childhood associated with Crohn's disease. A 3-year-old girl was admitted to the hospital because of a splenic abscess with protracted enterocolitis. The splenic abscess did not respond to intravenous antibiotic injection therapy. So we inserted catheters into the splenic artery, and antibiotic drugs were administered through the catheters by using interventional radiology (IVR). Thereafter, a splenectomy was performed. There was no intraabdominal infectional complication. Her postoperative course was uneventful at first, but soon she developed necrotizing pyoderma on the right dorsum manus, anal fissure, oral aphtha, and then hematochezia and diarrhea. Crohn's disease was diagnosed with colonoscopic findings and other clinical complications.
As in our case, IVR seems to be an effective treatment for splenic abscess. From the standpoint of preserving the spleen for childhood splenic abscess, IVR is thought to be the therapy of choice. And a pssibility of inflammatory intestinal disease must be kept in mind as an underlying disorder of splenic abscess associated with protracted enterocolitis.
This case is the 40th case of splenic abscess in childhood in Japan. Some discussion on the etiology and management of this disease is also presented.
