Endoskopie heute 2013; 26(3): 223-225
DOI: 10.1055/s-0033-1350600
Kasuistik
© Georg Thieme Verlag KG Stuttgart · New York

Septischer Milzinfarkt bei Aortenklappenendokarditis

Septic Splenic Embolism Due to Endocarditis
U. Gottschalk
1   Abteilung Innere Medizin/Gastroenterologie, Caritas-Klinik Pankow, Berlin
,
T. Zinner
2   Abteilung Viszeralchirurgie, Caritas-Klinik Pankow, Berlin
› Author Affiliations
Further Information

Publication History

Publication Date:
09 October 2013 (online)

Zusammenfassung

Abszesse der Milz sind sehr selten zu diagnostizieren. Diese können akut mit Oberbauchschmerzen auftreten und stellen eine Herausforderung zur effektiven Diagnostik an den Arzt in der Rettungsstelle dar. Die häufigste Ursache ist die Endokarditis, wobei Patienten mit Abszessen häufiger operiert werden müssen und auch eine höhere Krankenhausmortalität aufweisen. Therapie der Wahl sind Antibiotika, Drainagen, die Splenektomie und der Herzklappenersatz.

Abstract

Abscess of the spleen is a very rare lesion. Acute abdominal pain related to splenic infarction may be obscured, and the diagnosis is quite challenging even for experienced physicians or surgeons. Patients with endocarditis who develop abscesses are more likely to undergo surgery than who do not, and also their in-hospital mortality rate is higher. The treatment of choice has been antibiotics, drainage, splenectomy, and valve replacement surgery.

 
  • Literatur

  • 1 Wang CC, Lee CH, Chan CY et al. Splenic infarction and abscess complicating infective endocarditis. The American journal of emergency medicine 2009; 27: 1021 e–35
  • 2 Ulhaci N, Meteoglu I, Kacar F et al. Abscess of the spleen. Pathology oncology research: POR 2004; 10: 234-236
  • 3 Mocchegiani R, Nataloni M. Complications of infective endocarditis. Cardiovascular & hematological disorders drug targets 2009; 9: 240-248
  • 4 Ting W, Silverman NA, Arzouman DA et al. Splenic septic emboli in endocarditis. Circulation 1990; 82: IV105-IV109
  • 5 Bessho H, Ichihara I, Takii M. A case of splenic abscess due to Chlamydia pneumoniae. Diagnostic microbiology and infectious disease 2001; 39: 261-264
  • 6 Zellweger C, Zimmerli S. Candida albicans endocarditis. A rare disease with serious complications. Deutsche medizinische Wochenschrift 2003; 128: 1048-1050
  • 7 Conzo G, Docimo G, Palazzo A et al. The role of percutaneous US-guided drainage in the treatment of splenic abscess. Case report and review of the literature. Annali italiani di chirurgia 2012; 83: 433-436
  • 8 Aoyagi S, Kosuga T, Ogata T et al. Spontaneous rupture of the spleen caused by a Bacillus infection: report of a case. Surgery today 2009; 39: 733-737
  • 9 Gorg C, Zugmaier G. Chronic recurring infarction of the spleen: sonographic patterns and complications. Ultraschall in der Medizin 2003; 24: 245-249
  • 10 Gottschalk U, Dietrich C. Materialkunde. In: Dietrich C, Nürnberg D. Interventioneler Ultraschall. Stuttgart, New York: Georg Thieme Verlag; 2011
  • 11 Gorg C, Graef C, Bert T. Contrast-enhanced sonography for differential diagnosis of an inhomogeneous spleen of unknown cause in patients with pain in the left upper quadrant. Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 2006; 25: 729-734