Synonym.—Abscess of the Spleen.
Etiology.—This is due to infection from pyogenic micro-organisms, and may be introduced through an extension of a suppurative inflammation from a neighboring part, from the perforation of a gastric ulcer, from the lodgment of an infected thrombus, derived from an ulcerative endocarditis or other pyemic foci. It may also be due to the infectious fevers, especially typhoid, typhus, and relapsing fever. The micro-organisms may be introduced directly through a wound.
Pathology.—In most cases the abscesses are small and scattered throughout the organ, or there may be a single abscess varying in size from a walnut to one of enormous size, the degenerated organ appearing as an immense pus sac. The abscess may rupture into the stomach, the colon, the peritoneal cavity, or, perforating the diaphragm, empty into the pleura or lung.
Symptoms.—If the abscess be small and deeply seated, there may be an entire absence of symptoms; but where the abscess is very large, there will be pain in the affected organ, some tenderness, and more or less enlargement.
The irregular fever of septic conditions is present. Should the abscess rupture, the symptoms will depend upon where it empties,—into the peritoneum, colon, stomach, or, perforating the diaphragm, open into the pleura or lung.
Prognosis.—If the abscess be small, there may be but little danger, but when very large the case is grave and the prognosis must be guarded.
Treatment.—In the early stage, the use of the antiseptics will be called for; but when the abscess is large, and the irregular fever tells us of the presence of pus, the treatment is purely surgical.