Splenic artery and vein
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Splenic artery aneurysm
Artery and splenic vein
Abnormalities of the spleen
Ultrasound images Abscess of spleen
Ultrasound images Splenic abscesses are relatively uncommon compared with their incidence in the liver. They usually result from blood-borne bacterial infection, but can also be due to amoebic infection, post-traumatic or fungal infection. Patients with splenomegaly resulting from typhoid fever, malaria and sickle cell disease are particularly predisposed to the formation of multiple pyogenic abscesses in the spleen. Increasingly splenic abscesses are associated with immunosuppressed patients, patients with AIDS and those on high-dose chemotherapy. Such patients become susceptible to invasive fungal infections which can cause multifocal microabscesses in the liver and spleen. Patients present, as might be expected, with LUQ pain and fever. The ultrasound appearances are similar to liver abscesses; they may be single or multiple, hyperechoic and homogeneous in the early stages, progressing to complex, fluid-filled structures with increased through-transmission (Fig. below). Splenic abscesses are frequently hypoechoic and it may not be possible to differentiate abscess from lymphoma or metastases on ultrasound appearances alone. This applies both in cases of large solitary abscesses and in multifocal micro-abscesses. They may also contain gas, posing difficulties for diagnosis as the area may be mistaken for overlying bowel. As with liver abscesses, percutaneous drainage with antibiotic therapy is the management of choice for solitary abscesses.
ultrasound images Large splenic abscess in an immunosuppressed patient following hepatic transplantation.
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